[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.

MATERIAL

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