title: Use of the intrauterine device: efficacy and safety.
abstract: OBJECTIVE
  To characterize the family planning center population that used an intrauterine device (IUD), to compare the reasons for its removal and types of incidents encountered by nulliparous women and women with children, and to evaluate the efficacy and safety of this method by the use of life tables.
  
  
  METHODS
  This was an observational, descriptive, prospective study of 774 women, recruited over a 5-year period, who used an IUD by informed choice, presented no absolute contraindications and were assessed throughout the whole follow-up period.
  
  
  RESULTS
  The mean age (standard deviation) of IUD use was 32.8 (5.9) years for non-nulliparous women and 27.4 (5.3) years for nulliparous women (p < 0.001). Follow-up was completed at the family planning center for 80.1% of women. No differences were observed between nulliparous and non-nulliparous women with respect to accidental pregnancy, suspected pelvic inflammatory disease or expulsion. Non-nulliparous women experienced more major bleeding incidents and anemia (p = 0.010). All pregnancies occurred with low-load devices. Nulliparous women discontinued IUD use more often due to a desire to become pregnant (p = 0.009) and suffered more vulvovaginal infections (p = 0.044).
  
  
  CONCLUSIONS
  The IUD is a safe contraceptive option regardless of parity, provided that women are carefully selected.
authors.affiliation: Family Planning and Advice Center, Municipal Health Care Institute, Barcelona Health Care Consortium, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ramírez Hidalgo
authors.forename: E
authors.initials: E
authors.lastname: Pujol Ribera
mesh_terms: D000328:Adult; D005193:Family Planning Services; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects* / Q000706:statistics & numerical data*; D008499:Medical Records; D010298:Parity; D010349:Patient Compliance; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology