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Uterine perforation is a dreaded complication of intrauterine-device (IUD) placement. Investigators searched a Finnish national registry covering a 14-year period to identify cases of women who underwent surgical removal of an IUD following perforation. A total of 68 perforations associated with copper-containing IUDs and levonorgestrel-containing intrauterine systems were analyzed together and separately.
Using data on IUD sales by one pharmaceutical company that accounted for >90% of all devices sold nationally, the investigators estimated that the overall incidence of perforation was 0.4 per 1000 devices sold, regardless of the type of intrauterine contraception. More than half of cases (55%) occurred in association with placement <6 mont…