title: A retrospective evaluation of the intrauterine device in a patient population in Buenos Aires, Argentina.
abstract: BACKGROUND
  The intrauterine device (IUD) is a long-acting reversible contraceptive method that is safe for a wide range of women, including adolescents and nulliparous women. Globally, it is often underutilised due to misperceptions among patients. Examination of characteristics associated with IUD discontinuation including adverse effects and IUD expulsion can inform provider practices to improve contraception success and patient satisfaction with this method. We studied IUD performance at a public family planning clinic in Buenos Aires, Argentina, serving a predominantly immigrant, low-income population.
  
  
  METHODS
  We conducted a retrospective evaluation of 1047 IUD insertions between 2002 and 2007 with 5 years of follow-up data. We performed bivariate and survival analysis to examine characteristics associated with IUD discontinuation: adverse outcomes including pain, bleeding, and IUD expulsion, and time to removal.
  
  
  RESULTS
  Of 1047 patients, only 188 (18%) had their IUD removed within 5 years. The main causes of IUD discontinuation were involuntary (38%) reasons such as an IUD expulsion and personal choice (34%) such as desiring pregnancy.
  
  
  CONCLUSIONS
  Findings suggest overall good long-term performance with IUD insertion, with minimal complaints or adverse outcomes. These findings may help to support providers serving similar populations in promoting this method.
authors.affiliation: Education, Research and Training Associate, Physicians for Reproductive Health (work was conducted while at Stony Brook University), New York, NY 10018, USA.
authors.forename: Sherani R
authors.identifier: http://orcid.org/0000-0001-7537-0223
authors.initials: SR
authors.lastname: Jagroep
authors.affiliation: Howard University College of Medicine, MS1 (work was conducted while at Stony Brook University), Washington DC, 20001.
authors.forename: Margaret S
authors.identifier: http://orcid.org/0000-0002-9132-4400
authors.initials: MS
authors.lastname: Pichardo
authors.affiliation: Obstetrician Gynecologist, Department of Gynecology, Hospital Bernardino Rivadavia, Buenos Aires Ministry of Health, Buenos Aires, Argentina.
authors.forename: Lia
authors.initials: L
authors.lastname: Arribas
authors.affiliation: Obstetrician Gynecologist, Department of Gynecology, Hospital Bernardino Rivadavia, Buenos Aires Ministry of Health, Buenos Aires, Argentina.
authors.forename: Graciela
authors.initials: G
authors.lastname: Heredia
authors.affiliation: Obstetrician Gynecologist, Department of Gynecology, Hospital Bernardino Rivadavia, Buenos Aires Ministry of Health, Buenos Aires, Argentina.
authors.forename: Elina
authors.initials: E
authors.lastname: Coccio
authors.affiliation: Assistant Professor, Program in Public Health, Department of Preventative Medicine, Stony Brook University (State University of New York), Health Sciences Center 3-021, Stony Brook, NY 11790, USA.
authors.forename: Tia M
authors.identifier: http://orcid.org/0000-0003-0419-2049
authors.initials: TM
authors.lastname: Palermo
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001118:Argentina; D015331:Cohort Studies; D003267:Contraception / Q000295:instrumentation* / Q000379:methods; D004869:Equipment Safety; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014505:Urban Population; D055815:Young Adult
keywords: intrauterine devices; long-acting reversible contraception