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Same-Day Intrauterine Device Placement is Rarely Complicated by Pelvic Infection

Published:November 25, 2014DOI:https://doi.org/10.1016/j.whi.2014.09.006

      Abstract

      Purpose

      To compare rates of pelvic inflammatory disease (PID) among women who did and did not receive an intrauterine device (IUD) the day they sought emergency contraception (EC) or pregnancy testing.

      Methods

      Women, 15 to 45 years of age, who sought EC or pregnancy testing from an urban family planning clinic completed surveys at the time of their clinic visit (August 22, 2011, to May 30, 2013) and 3 months after their clinic visit. The surveys assessed contraceptive use and symptoms, testing, and treatment for sexually transmitted infections (STI) and PID. We reviewed the medical records of participants who reported IUD placement within 3 months of enrollment and abstracted de-identified electronic medical record (EMR) data on all women who sought EC or pregnancy testing from the study clinic during the study period.

      Findings

      During the study period, 1,060 women visited the study clinic; 272 completed both enrollment and follow-up surveys. Among survey completers with same-day IUD placement, PID in the 3 months after enrollment was not more common (1/28 [3.6%]; 95% CI, 0%–10.4%) than among women who did not have a same-day IUD placed (11/225 [4.9%]; 95% CI, 2.7%–8.6%; p = .71). Chart review and EMR data similarly showed that rates of PID within 3 months of seeking EC or pregnancy testing were low whether women opted for same-day or delayed IUD placement.

      Conclusions

      Same-day IUD placement was not associated with higher rates of PID. Concern for asymptomatic STI should not delay IUD placement, and efforts to increase the uptake of this highly effective reversible contraception should not be limited to populations at low risk of STI.
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      Biography

      Melissa Papic, BS, is a Data Manager in the Department of Epidemiology at the University of Pittsburgh. Her research interests include women's health, and maternal and child health research.

      Biography

      Nan Wang, BS, is a Medical Student at the University of Pittsburgh School of Medicine.

      Biography

      Sara M. Parisi, MS, MPH, is a Data Analyst in the Department of Epidemiology at the University of Pittsburgh. Her research interests include women's health, and maternal and child health research.

      Biography

      Erin Baldauf, MEd, is a Research Coordinator at the Center for Research on Health Care at the University of Pittsburgh. Her research interests include women's health research.

      Biography

      Glenn Updike, MD, is the Medical Director at the Magee-Womens Hospital Outpatient Clinic; and Assistant Professor in the Department of Obstetrics, Gynecology, & Reproductive Sciences at the University of Pittsburgh. His research interests include women's health research.

      Biography

      Eleanor Bimla Schwarz, MD, MS, is a Professor of Medicine at the University of California, Davis. Her research interests include women's health, and maternal and child health research.