Intrauterine contraceptive devices and risk of pelvic inflammatory disease: standard of care in high STI prevalence settings

Reproductive Health Matters
Richard Steen, Katharine Shapiro

Abstract

The intrauterine contraceptive device (IUD) is highly effective and cost-effective. IUD use is limited in some regions, however, due to concerns about increased risk of pelvic inflammatory disease (PID) and subsequent complications such as infertility and ectopic pregnancy. Recent reviews suggest that the overall risk of PID with modern IUDs is lower than previously thought, at least in regions with a low prevalence of sexually transmitted infections (STIs). Risk of PID may be higher, however, in places where gonorrhoea and chlamydia are prevalent, where screening for STIs is limited and where aseptic conditions for insertion are difficult to ensure. A World Health Organization multi-centre study and other studies have confirmed regional differences in STI prevalence, and the WHO study established that PID risk is temporally related to IUD insertion procedures. Studies of the effectiveness of antibiotic prophylaxis to prevent infectious complications are inconclusive due at least in part to use of sub-therapeutic regimens for pathogens commonly implicated in PID. In summary, the IUD can be safe and effective if inserted under aseptic conditions in women free of cervical infection. Further study is needed to define appropriate s...Continue Reading

References

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Citations

May 1, 2008·Sexually Transmitted Diseases·Carolina PorrasUNKNOWN Costa Rica HPV Vaccine Trial (CVT) Group
Nov 30, 2012·AIDS Research and Treatment·Erica Gollub, Zena Stein
Sep 10, 2011·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Mark ErianDavid Baartz
Jan 17, 2013·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·Thérèse Delvaux, Anne Buvé
Jul 23, 2005·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·H M TanirT Oge
Mar 18, 2008·Contraception·John Stanback, James D Shelton
May 29, 2007·Reproductive Health Matters·Thérèse Delvaux, Christiana Nöstlinger
May 29, 2007·Contraception·Anita L Nelson
Nov 15, 2006·Reproductive Health Matters·Marge Berer
Jun 23, 2005·Journal of Pediatric and Adolescent Gynecology·Angela Nicoletti, Margaret Tonelli
Aug 11, 2007·American Journal of Obstetrics and Gynecology·Samuel J CampbellCatherine A Matthews
Mar 9, 2006·American Journal of Obstetrics and Gynecology·Jimmy EspinozaRoberto Romero
Sep 11, 2007·Journal of Midwifery & Women's Health·Elizabeth K Kelly, Sarah W Rudinsky
Nov 10, 2005·Journal of Medical Microbiology·Z PálE Nagy
Jul 25, 2019·Revista da Associação Médica Brasileira·Paulo César GiraldoJosé Marcos Sanches

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