| The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD). | |
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MedLine Citation:
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PMID: 19650756 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Intrauterine devices (IUDs) are used for contraception worldwide; however, the management of pregnancies with an IUD poses a clinical challenge. The purpose of this study was to determine the outcome of pregnancy in patients with an IUD. STUDY DESIGN: A retrospective cohort study (December 1997-June 2007) was conducted. The cohort consisted of 12,297 pregnancies, of which 196 had an IUD. Only singleton pregnancies were included. Logistic regression analysis was used to adjust for potential confounders between the groups. RESULTS: 1) Pregnancies with an IUD were associated with a higher rate of late miscarriage, preterm delivery, vaginal bleeding, clinical chorioamnionitis, and placental abruption than those without an IUD; 2) among patients with available histologic examination of the placenta, the rate of histologic chorioamnionitis and/or funisitis was higher in patients with an IUD than in those without an IUD (54.2% vs. 14.7%; P<0.001). Similarly, among patients who underwent an amniocentesis, the prevalence of microbial invasion of the amniotic cavity (MIAC) was also higher in pregnant women with an IUD than in those without an IUD (45.9% vs. 8.8%; P<0.001); and 3) intra-amniotic infection caused by Candida species was more frequently present in pregnancies with an IUD than in those without an IUD (31.1% vs. 6.3%; P<0.001). CONCLUSION: Pregnant women with an IUD are at a very high risk for adverse pregnancy outcomes. This finding can be attributed, at least in part, to the high prevalence of intra-amniotic infection and placental inflammatory lesions observed in pregnancies with an IUD. |
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Authors:
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Sun Kwon Kim; Roberto Romero; Juan Pedro Kusanovic; Offer Erez; Edi Vaisbuch; Shali Mazaki-Tovi; Francesca Gotsch; Pooja Mittal; Tinnakorn Chaiworapongsa; Percy Pacora; Giovanna Ogg?; Ricardo Gomez; Bo Hyun Yoon; Lami Yeo; Ronald F Lamont; Sonia S Hassan |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Intramural |
Journal Detail:
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Title: Journal of perinatal medicine Volume: 38 ISSN: 1619-3997 ISO Abbreviation: J Perinat Med Publication Date: 2010 |
Date Detail:
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Created Date: 2010-01-05 Completed Date: 2010-04-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0361031 Medline TA: J Perinat Med Country: Germany |
Other Details:
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Languages: eng Pagination: 45-53 Citation Subset: IM |
Affiliation:
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Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland and Detroit, Michigan, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniotic Fluid / microbiology Chile / epidemiology Cohort Studies Female Humans Infant, Newborn Intrauterine Devices* Placenta / pathology Pregnancy Pregnancy Complications / epidemiology*, microbiology, pathology Pregnancy Outcome Prognosis Retrospective Studies Young Adult |
| Comments/Corrections | |
Comment In:
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J Perinat Med. 2010 Mar;38(2):223
[PMID:
20199339
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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