title: Rare events occurring at insertion of an intrauterine device--a review of an international experience.
abstract: Events occurring at the time of insertion of an intrauterine device (IUD) are rarely studied, especially for parous women for whom, in theory, IUD contraception is most suitable. These events, although rare, cause personal distress, embarrassment and inconvenience and can have a negative impact on IUD acceptance. Sixty million women worldwide are using IUDs. Thus, even a rare event may have important public health implications. To avoid such occurrences, the risk factors of these rare events need to be delineated. The large international IUD data set compiled by Family Health International (FHI) since 1972 provides a unique opportunity to achieve this purpose. Four IUD insertion-related rare events have been studied, namely: insertion failure, uterine perforation, syncope and other vasovagal reactions, and severe insertional pain. This review paper summarizes the important findings from these as well as other relevant studies. This broad experience should form the basis by which health personnel inserting IUDs can improve the quality of care for women requesting a device for contraception.
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007433:Intrauterine Device Expulsion; D007434:Intrauterine Devices / Q000009:adverse effects*; D007435:Intrauterine Devices, Copper / Q000009:adverse effects; D010146:Pain; D010349:Patient Compliance; D012306:Risk; D013575:Syncope / Q000209:etiology; D014595:Uterine Perforation / Q000209:etiology