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IUD-associated hospitalization in less developed countries.

I C Chi, L Laufe and S Rogers

Data on 11,977 insertions of an intrauterine device (IUD) from 25 collaborating centers in 16 less developed countries (LDCs) were investigated for IUD-associated hospitalizations. These centers maintained regular follow-up and reported at least one hospitalization among their IUD cases. The Lippes Loop, Copper T, Delta Loop, and Delta T were the most commonly used devices, and three-fourths of all devices were inserted in postpartum women. Fifty-five of the 128 reported subsequent hospitalizations were associated with IUD use. Main indications for IUD-associated hospitalizations were pelvic infection, bleeding/pain, and method failure. Statistically significant differences were not detected in the three-month gross cumulative rates for hospitalizations due to IUD complications by age (less than 30 vs 30+), parity (0-1 vs 2+), or device type (Lippes Loop and Copper T vs Delta devices vs others). Three types of IUD-associated hospitalization rates were calculated, each involving a margin of error: 1) a Pearl rate of 8.0 per 1,000 woman-years of IUD use; 2) a one-year life table rate of 6.3 per 1,000 insertions; and 3) crude rates ranging from 3.2 to 4.6 per 1,000 cases.