Emergency intrauterine device insertion in teenagers: an informal retrospective study

Abstract

Background Widespread and increased availability of oral emergency contraception (EC) over the past 10 years has made little difference to rates of unintended pregnancy, abortion and repeat abortion amongst teenagers. The insertion of an intrauterine device for EC (EC-IUD) is 98-99% effective compared with 85% for oral methods and can be used for ongoing, long-term reversible contraception. However this method is seldom used for teenagers, a group with a high risk of unintended pregnancy, and there is little published data on the use of EC-IUD in this group. Methods An anonymous case note review of EC-IUD use in teenagers in three centres in the UK was conducted to quantify provision, to identify insertion difficulties and short-term complications and to ascertain compliance with national guidance concerning sexually transmitted infection (STI) risk assessment and prophylaxis. Results A total of 103 cases was identified over 4 years (2007)(2008)(2009)(2010) from the three centres (London, Liverpool and Aberdeen). The results show that the majority of fittings were straightforward (94%) with few complications. Antibiotic prophylaxis was deemed necessary in 64% of attenders. Conclusions The authors recommend that with STI screening and appropriate antibiotic prophylaxis, use of IUDs in women under the age of 20 years should be unrestricted both for long-term contraception and for EC.

<p>The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update</p>

“…Three of the Chinese studies18,24,28 tried to give estimates of efficacy for the copper IUD and the comparator group using Dixon’s method 30. The UK study was from multiple clinics and consisted of 103 patients of whom 64 were given oral EC and then the copper IUD as well, within 5 days 13. Only the 38 subjects who were not given oral EC have been included.…”