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Pelvic inflammatory disease among users and non-users of an intrauterine device.
J Obstet Gynaecol. 2021 Jan; 41(1):118-123.JO

Abstract

The correlation between pelvic inflammatory disease (PID) and a present intrauterine device (IUD) has been debated. We aimed to evaluate the differences between IUD users and non-users among women hospitalised with a diagnosis of PID. Our hypothesis was that the role of a present IUD among PID patients is minimal, if any. We performed a retrospective cohort study during 2010-2018 in a tertiary university hospital. Overall, 474 hospitalised patients were diagnosed with PID. Of these, 121 patients were IUD users. The patients without an IUD were younger and had lower gravidity and parity. Among the patients without an IUD, higher rates of prior history of PID and fever at presentation were noticed. In 23.9% (29/121) of women, the IUD was inserted less than four weeks prior to the PID diagnosis. The patients with an IUD insertion-associated PID, had lower rates of tubo-ovarian abscess (2 (6.9%) versus 24 (26.0%), OR [95% CI] 0.18 (0.04-0.84), p = .02) at presentation, as well as a shorter length of stay (LOS) (median 4 versus 5 days, p = .05). In a patient in whom the IUD was retained, hospitalisation period was shorter (median LOS 4 days versus 5 days, p = .007). PID inpatients who carry an IUD represent a specific subset of patients with a milder disease.Impact statementWhat is already known on this subject? The correlation between pelvic inflammatory disease (PID) and a present intrauterine device (IUD) is debateable.What the results of this study add? PID inpatients who carry an IUD represent a specific subset of patients with milder disease.What the implications are of these findings for clinical practice and/or further research? Our results show that in IUD users with PID, the practice of IUD removal as part of their PID treatment is of little benefit.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32148134

Citation

Levin, Gabriel, et al. "Pelvic Inflammatory Disease Among Users and Non-users of an Intrauterine Device." Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, vol. 41, no. 1, 2021, pp. 118-123.
Levin G, Dior UP, Gilad R, et al. Pelvic inflammatory disease among users and non-users of an intrauterine device. J Obstet Gynaecol. 2021;41(1):118-123.
Levin, G., Dior, U. P., Gilad, R., Benshushan, A., Shushan, A., & Rottenstreich, A. (2021). Pelvic inflammatory disease among users and non-users of an intrauterine device. Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology, 41(1), 118-123. https://doi.org/10.1080/01443615.2020.1719989
Levin G, et al. Pelvic Inflammatory Disease Among Users and Non-users of an Intrauterine Device. J Obstet Gynaecol. 2021;41(1):118-123. PubMed PMID: 32148134.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pelvic inflammatory disease among users and non-users of an intrauterine device. AU - Levin,Gabriel, AU - Dior,Uri P, AU - Gilad,Ronit, AU - Benshushan,Avi, AU - Shushan,Asher, AU - Rottenstreich,Amihai, Y1 - 2020/03/09/ PY - 2020/3/10/pubmed PY - 2020/3/10/medline PY - 2020/3/10/entrez KW - Intrauterine device KW - intrauterine device culture KW - intrauterine device removal KW - pelvic inflammatory disease KW - tubo-ovarian abscess SP - 118 EP - 123 JF - Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology JO - J Obstet Gynaecol VL - 41 IS - 1 N2 - The correlation between pelvic inflammatory disease (PID) and a present intrauterine device (IUD) has been debated. We aimed to evaluate the differences between IUD users and non-users among women hospitalised with a diagnosis of PID. Our hypothesis was that the role of a present IUD among PID patients is minimal, if any. We performed a retrospective cohort study during 2010-2018 in a tertiary university hospital. Overall, 474 hospitalised patients were diagnosed with PID. Of these, 121 patients were IUD users. The patients without an IUD were younger and had lower gravidity and parity. Among the patients without an IUD, higher rates of prior history of PID and fever at presentation were noticed. In 23.9% (29/121) of women, the IUD was inserted less than four weeks prior to the PID diagnosis. The patients with an IUD insertion-associated PID, had lower rates of tubo-ovarian abscess (2 (6.9%) versus 24 (26.0%), OR [95% CI] 0.18 (0.04-0.84), p = .02) at presentation, as well as a shorter length of stay (LOS) (median 4 versus 5 days, p = .05). In a patient in whom the IUD was retained, hospitalisation period was shorter (median LOS 4 days versus 5 days, p = .007). PID inpatients who carry an IUD represent a specific subset of patients with a milder disease.Impact statementWhat is already known on this subject? The correlation between pelvic inflammatory disease (PID) and a present intrauterine device (IUD) is debateable.What the results of this study add? PID inpatients who carry an IUD represent a specific subset of patients with milder disease.What the implications are of these findings for clinical practice and/or further research? Our results show that in IUD users with PID, the practice of IUD removal as part of their PID treatment is of little benefit. SN - 1364-6893 UR - https://www.unboundmedicine.com/medline/citation/32148134/Pelvic_inflammatory_disease_among_users_and_non-users_of_an_intrauterine_device. L2 - https://www.tandfonline.com/doi/full/10.1080/01443615.2020.1719989 DB - PRIME DP - Unbound Medicine ER -
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