An assessment of the infection risk associated with intrauterine device
insertion in two different clinical situations
C. Johnman
The Sandyford Initiative, Glasgow, UK
Objective: The presence of a sexual infection at the time of an
intrauterine device (IUD) insertion increases the risk of pelvic inflammatory
disease (PID) developing. There is some evidence that there is a higher rate of
sexual infections in women who are attending for post-coital contraception (PCC)
IUD’s than in those who had their IUD’S inserted as an elective procedure.
We wished to examine this in our community based sexual health service.
Methods: Using the department’s computerised records system it was
possible to access the records for all of the elective and PCC IUD’s fitted in
the last quarter of 2001. The data was entered into Microsoft Access and then
analysed using SSPS. Basic information about the age and parity of the woman was
collected as well as the number, type and result of swabs taken.
Results:
| Elective | PCC | |
| Mean age | 37 | 25 |
| Median age | 34 | 24 |
| Nulliparous | 25% | 61.5% |
| Previous TOP | 20% | 20% |
| Chlamydia positive | 0.65% | 6.67% |
There were no cases of gonorrhoea in either group. The PCC group were younger,
more often nulliparous and had the higher incidence of Chlamydia but
interestingly both groups had had an equivalent number of termination of
pregnancies.
Conclusion: Having an IUD fitted for emergency contraception rather
than, as an elective procedure is associated with an increase risk of an
infection being present.
