Uterine perforation in women using a levonorgestrel-releasing intrauterine system.
OBJECTIVE
To determine an estimated incidence of uterine perforations related to the insertion of a levonorgestrel-releasing intrauterine system (LNG IUS) and to identify possible risk factors.


METHODS
Retrospective, case report study.


METHODS
Hospitals in Limburg, the Netherlands.


METHODS
Gynecologists in hospitals in Limburg were asked about uterine perforations related to the insertion of a LNG IUS between 1999 and 2002. The charts of the reported perforations were studied. Data on the patient, doctor, insertion, diagnosis and removal were collected for every reported uterine perforation.


RESULTS
In Limburg, the estimated incidence of uterine perforations related to the insertion of a LNG IUS is 2.6 per 1000 insertions. Insertion in lactating women, even beyond 6 weeks after delivery, was shown to be an important risk factor.


CONCLUSIONS
Complete registration of complications provides a greater insight into the actual incidence of LNG IUS-related uterine perforations and their possible consequences. This may eventually lead to a decrease in complications.
Van Houdenhoven
K
K
Department of Obstetrics and Gynaecology, AZ Sint Maarten Hospital, 2800 Mechelen, Belgium. kvanhoudenhoven@hotmail.com
van Kaam
K J A F
KJ
van Grootheest
A C
AC
Salemans
T H B
TH
Dunselman
G A J
GA
D000328:Adult; D016022:Case-Control Studies; D003280:Contraceptives, Oral, Synthetic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects*; D016912:Levonorgestrel / Q000009:adverse effects*; D009426:Netherlands; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D014595:Uterine Perforation / Q000209:etiology*
D003280:Contraceptives, Oral, Synthetic; D016912:Levonorgestrel