title: Same-day intrauterine device placement is rarely complicated by pelvic infection.
abstract: OBJECTIVE
  To compare rates of pelvic inflammatory disease (PID) among women who did and did not receive an intrauterine device (IUD) the day they sought emergency contraception (EC) or pregnancy testing.
  
  
  METHODS
  Women, 15 to 45 years of age, who sought EC or pregnancy testing from an urban family planning clinic completed surveys at the time of their clinic visit (August 22, 2011, to May 30, 2013) and 3 months after their clinic visit. The surveys assessed contraceptive use and symptoms, testing, and treatment for sexually transmitted infections (STI) and PID. We reviewed the medical records of participants who reported IUD placement within 3 months of enrollment and abstracted de-identified electronic medical record (EMR) data on all women who sought EC or pregnancy testing from the study clinic during the study period.
  
  
  RESULTS
  During the study period, 1,060 women visited the study clinic; 272 completed both enrollment and follow-up surveys. Among survey completers with same-day IUD placement, PID in the 3 months after enrollment was not more common (1/28 [3.6%]; 95% CI, 0%-10.4%) than among women who did not have a same-day IUD placed (11/225 [4.9%]; 95% CI, 2.7%-8.6%; p = .71). Chart review and EMR data similarly showed that rates of PID within 3 months of seeking EC or pregnancy testing were low whether women opted for same-day or delayed IUD placement.
  
  
  CONCLUSIONS
  Same-day IUD placement was not associated with higher rates of PID. Concern for asymptomatic STI should not delay IUD placement, and efforts to increase the uptake of this highly effective reversible contraception should not be limited to populations at low risk of STI.
authors.affiliation: Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Melissa
authors.initials: M
authors.lastname: Papic
authors.affiliation: School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Nan
authors.initials: N
authors.lastname: Wang
authors.affiliation: Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Parisi
authors.affiliation: Department of Medicine, Center for Research on Health Care, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Erin
authors.initials: E
authors.lastname: Baldauf
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Glenn
authors.initials: G
authors.lastname: Updike
authors.affiliation: Department of Medicine, University of California, Davis, Sacramento, California. Electronic address: ebschwarz@ucdavis.edu.
authors.forename: Eleanor Bimla
authors.initials: EB
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D000328:Adult; D044363:Contraception, Postcoital / Q000009:adverse effects* / Q000706:statistics & numerical data; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007434:Intrauterine Devices / Q000009:adverse effects* / Q000706:statistics & numerical data; D008403:Mass Screening; D008875:Middle Aged; D034161:Pelvic Infection / Q000453:epidemiology / Q000209:etiology; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology / Q000209:etiology*; D017699:Pelvic Pain / Q000453:epidemiology / Q000209:etiology; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy; D014505:Urban Population; D055815:Young Adult