The T 380A intrauterine device: a retrospective 5-year evaluation.
BACKGROUND
The undue resistance to intrauterine device (IUD) use seen in several settings does not seem to occur in the Family Planning Unit of UNIFESP-EPM (São Paulo Federal University, Brazil). In fact, the Copper T 380A IUD in this clinic has reached an outstanding importance and this motivated us to present our differing experience. The prevalence of this method in this clinic is as high as 40%. This contrasts to the low use in the rest of the country, where tubal ligation is by far the most used contraceptive method (40%) and where IUD is inexpressive (1.1%).


METHODS
This is a retrospective study of the records of 118 users of Copper T 380A IUD inserted at the clinic and who were followed during 5 years.


RESULTS
The cumulative pregnancy rate was 0.8%. The main cause for discontinuation of the study was loss to follow-up (21.3%). Other reasons for the withdrawal of the device were personal option (13.6%), dislocation (11.7%) and pregnancy wish (3.4%). There was no withdrawal by pelvic inflammatory disease. Bleeding (0.8%) was not an important cause for withdrawal, and there were no withdrawals due to pain. The continuation rate at 5 years was 46.7%. The structured service and an adequate educative program perhaps could explain at least partially the good performance of IUD use in this clinic. There was an amazing prevalence of the components of the metabolic syndrome. This could represent contraindications for hormonal contraception, and, in consequence, it could influence the increased option for and continuation of the IUD.


CONCLUSIONS
These data show a good performance of the IUD for long duration, in relation to other studies, and this should be considered as a reliable alternative to the high prevalence of female sterilization in this country.
de Araujo
Fabio Fernando
FF
Family Planning Unit, São Paulo Federal University (UNIFESP-EPM), São Paulo, Brazil. draraujoff@yahoo.com.br
Barbieri
Márcia
M
Guazzelli
Cristina Aparecida Falho
CA
Lindsey
Prescilla Chow
PC
D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods*; D003276:Contraceptives, Oral; D000075202:Contraindications; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper / Q000706:statistics & numerical data*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013246:Sterilization, Tubal / Q000379:methods; D013997:Time Factors; D055815:Young Adult
D003276:Contraceptives, Oral