Twelve-month outcomes of rotated copper intrauterine devices after immediate postpartum insertion

OBJECTIVE(S): To describe clinical outcomes of copper intrauterine devices (Cu-IUDs) inserted immediately postpartum that subsequently assumed a rotated position. STUDY DESIGN: Secondary analysis of a postpartum IUD cohort using medical record data from women with rotated Cu T380A IUDs identified by transvaginal ultrasound 30-120 days after delivery who elected to maintain the device and were followed for 12 months. RESULTS: Among 2,105 insertions, 1,813 had follow-up data available. Ninety-three devices (5.1%) were rotated. Of these, 73 asymptomatic women elected to maintain the device and were followed for 12 months. Partial uterine perforation occurred in 24 (32.9%), partial expulsion in 2 (2.7%), and no pregnancies were observed. Overall, 35 women (47.9%) discontinued use, primarily due to perforation. CONCLUSIONS: Rotated postpartum Cu-IUDs were not associated with pregnancy and rarely expelled but frequently progressed to partial uterine perforation.