Anne A. Moore, DNP, APRN, FAANP

Regardless of the IUD's location within the uterus (but especially if it is low-lying), it should be removed whenever possible.

The copper intrauterine device (IUD; copper T380A) has a use rate of 17% in Turkey, making this highly effective method the most common form of modern contraception in that country. Researchers at a family planning facility in Ankara conducted a retrospective cohort study from 2005 to 2012 to evaluate pregnancy outcomes in women who conceived despite the presence of an IUD. Among 27,578 IUD users, 144 had intrauterine singleton pregnancies that they wanted to continue; of these, 114 women opted to have the IUD removed during the first trimester and 30 chose to retain it.

Term infants were delivered by 73 women (64%) in the IUD removal group and 11 (37%) in the IUD-retention group. Overall rates of adverse outcomes (e.g., miscarriage, intrauterine fetal death, preterm birth) were significantly lower in the IUD-removal group (37%) than in the IUD-retention group (63%). IUD location low within the uterus was particularly consequential: Among 71 women with low-lying IUDs, the 6 who retained them had even higher rates of adverse events than the 65 who chose removal (e.g., miscarriage rates of 67% vs. 17%).

Citation(s):

Ozgu-Erdinc AS et al. Outcome of intrauterine pregnancies with intrauterine device in place and effects of device location on prognosis. Contraception 2014 May; 89:426.