[Intrauterine devices in general practice: a prospective study of 300 insertions].
OBJECTIVE
To assess the effectiveness of management practices of copper intrauterine devices (IUD) in general medicine.


METHODS
and methods. A prospective study was conducted over a four-year period. Thirty-four experimented and volunteer general practitioners inserted 300 IUDs. Two hundred and ninety-seven patients were evaluated. A 375-mg copper IUD was used. Results are presented by 12-month device survival, cumulative discontinuation, and event rates per hundred women.


RESULTS
At the end of the study 19.8% (n=59) of the women were lost to follow-up. Exposure time to IUD was 9245 cycles. Mean exposure time was 3917 cycles. Discontinuation rates for IUD were 82%, 67%, and 31% at 12, 36, and 48 months respectively. Renewal rate for this contraceptive device was 31.5%. Results confirmed that IUD were highly effective in this population: Pearl index 0.51% with four pregnancies. A very low expulsion rate (1.68%) and good tolerance (cumulative removal rate for medical reasons at 60 months=6.1%) were observed. At the end of the study, 61.3% of the women included had no complaints and had their IUD removed for desired pregnancy, replacement or personal reasons.


CONCLUSIONS
Our findings are similar to reports in the literature; there was no evidence of differences between general practitioners and gynecologists. IUDs inserted by experimented general practitioners are safe and should continue to be offered as a contraceptive option for properly selected women. These findings suggest that specific training on contraceptives should be provided to interested general practitioners
Marret
H
H
Département de Gynécologie Obstétrique, Médecine Foetale et Reproduction Humaine, Hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours Cedex 1, France.
Golfier
F
F
Vollerin
F
F
Legoaziou
M-F
MF
Raudrant
D
D
D000328:Adult; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007433:Intrauterine Device Expulsion; D007435:Intrauterine Devices, Copper / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data*; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D012449:Safety; D016019:Survival Analysis; D013997:Time Factors