title: IUD--related uterine perforation: an epidemiologic analysis of a rare event using an international dataset.
abstract: An international dataset of 21,610 IUD insertions revealed 41 uterine perforations occurring at the time of, or subsequent to, insertion.  Dat were collected on standard forms.  Perforations were classified as confirmed, probable, or possible, based on the clinician's judgement and subsequent management.  The uterine perforation rate was estimated as between 1.9 and 3.6/1000 insertions.  13 of the total 41 perforations were reported from 2 of 72 cooperating clinics.  In 1 clinic, this center-clustering phenomenon suggested an effect of a high risk device.  In the other clinic, the effect of insertor (operator) inexperience was indicated.  A case-control analysis delineated previous cesarean section as a host risk factor (P0.05, McNemar's chi square).  Further investigation of this association by similar case-control studies is recommended.
authors.forename: I
authors.initials: I
authors.lastname: Chi
authors.forename: P J
authors.initials: PJ
authors.lastname: Feldblum
authors.forename: S M
authors.initials: SM
authors.lastname: Rogers
mesh_terms: D000367:Age Factors; D001695:Biology; D019411:Clinical Laboratory Techniques; D003267:Contraception; D036861:Delivery, Obstetric; D003933:Diagnosis; D004194:Disease; D004812:Epidemiologic Methods; D005193:Family Planning Services; D013502:General Surgery; D005835:Genitalia; D005836:Genitalia, Female; D015994:Incidence; D007434:Intrauterine Devices; D007435:Intrauterine Devices, Copper; D007436:Intrauterine Devices, Medicated; D013513:Obstetric Surgical Procedures; D010298:Parity; D010827:Physiology; D011154:Population Characteristics; D012106:Research; D012107:Research Design; D013223:Statistics as Topic; D013812:Therapeutics; D014566:Urogenital System; D014595:Uterine Perforation; D014599:Uterus
keywords: Age Factors; Biology; Contraception--side effects; Contraceptive Methods--side effects; Data Analysis; Delivery; Diseases; Epidemiologic Methods; Examinations And Diagnoses; Family Planning; Genital Effects, Female; Genitalia; Genitalia, Female; Incidence; Insertion; Iud, Copper Releasing; Iud, Hormone Releasing; Iud, Unmedicated; Iud--side effects; Laboratory Examinations And Diagnoses; Measurement; Obstetrical Surgery; Parity; Perforations; Physiology; Population At Risk; Population Characteristics; Research Methodology; Surgery; Treatment; Urogenital Effects; Urogenital System; Uterine Effects; Uterine Perforation; Uterus