Dimensions of the endometrial cavity and intrauterine device expulsion or removal for displacement: a nested case-control study

作者：Liang H; Li L; Yuan W; Zou Y; Gao E S; Duffy J M N; Wu S C^*

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2014, 121(8): 997-1004.

DOI：10.1111/1471-0528.12619

• Dimensions of the uterine cavity
• displacement
• expulsion
• MLCu375
• nested case-control study
• TCu380A

Objective To evaluate the effect of the dimensions of the uterine cavity in relation to the expulsion, or removal for displacement, of intrauterine devices (IUDs) MLCu375 and TCu380A. Design A case-control study nested in a multicentre clinical trial. Setting Eighteen family planning clinics in China. Population Forty-eight pairs of TCu380A users and 118 pairs of MLCu375 users. Methods The women were classified as cases if IUD expulsion or displacement occurred during the first year of follow-up after insertion. One control was randomly selected for each case matched by IUD model, centre, age, service provider for insertion, and date of insertion. Axial length of the uterine cavity (LUC) and the largest transverse diameter of the coronal section of the uterine cavity (LTD) were measured using abdominal ultrasound. We used multivariate conditional logistic regressions to estimate the adjusted odds ratios (aORs) of expulsions or displacements among women with different sizes of uterine cavity according to the quartile of LUC and LTD, respectively. Results Among MLCu375 users, women with LTD27mm had a higher risk of expulsion or displacement (aOR 2.40; 95% confidence interval, 95% CI, 1.02-5.63), after adjusting for the volume of menstrual flow, dysmenorrhoea, parity, uterine position, MLCu375 type, and LUC. Among TCu380A users, the association between LTD37mm and expulsion or displacement (aOR 4.98; 95%CI 1.01-22.49) was statistically significant, after adjusting for LUC and potential confounding factors. Conclusion Our study suggests that LTD should be considered when making the decision of which IUD model to use.

• 出版日期2014-7
• 单位上海市计划生育科学研究所; 国家卫生计生委科学技术研究所