Relation between ectopic pregnancy and IUD use

The association between ectopic pregnancy and the use of the IUD was analyzed using 62321 cases of pregnant women who came to the Drum Tower Hospital of Medical College Nanjing University China in the 7 years between January 1984 an December 1990. Among these pregnant women 2040 (3.3%) become pregnant with the IUD in situ 504 (0.81%) had ectopic pregnancies including 107 IUD users. The incidence of ectopic pregnancy showed a significant increase over the years. When studying ectopic pregnancies in IUD users and non-users it was found that the incidence of ectopic pregnancy was increasing for both groups. However the ratio between intra-uterine pregnancy and ectopic pregnancy for IUD users increased 7.6 times from 1984-1990. In 1990 the increase in ectopic pregnancy among IUD users was significantly higher than among non-users. An ultra-sound examination of 107 cases of ectopic pregnancy in IUD users suggested an association between ectopic pregnancy and the disposition if the IUD in the uterine cavity A comparison of the incidence of ectopic pregnancy by duration of IUD use showed that the occurrence of ectopic pregnancy decreases with the increase in duration of IUD use. Pathologic examination showed no increased inflammatory changes in the uterine cavity among the cases of ectopic pregnancy in IUD users which did not confirm the theory of association between inflammation of the uterine cavity with ectopic pregnancy. Further investigation is needed to explore the causes of ectopic pregnancy in IUD users.