자궁내장치의 위치이동

Abstract

Objective : To study intrauterine or extrauterine misplacement of intrauterine devices in respect to their usage in diagnosis and therapy via retrospective analysis. Methods : Data from 1993 to 2000 on a total of 32 patients from seven Catholic University branch hospitals who had been admitted to treat IUDs which had misplaced to intrauterine or extrauterine locations were analyzed for usage in a retrospective study. Results : The data for intrauterine and extrauterine misplacement revealed no significant difference between from the statistical average in relation to age, parity and duration of insertion. In terms of removal method, all 15 patients with extrauterine misplacement underwent surgical extraction by open or laparascopic method under general anesthesia, but those patients with intrauterine misplacement had their device removed after cervical dilatation with a laminaria using local anesthesia. Concerning diagnosis, 81.2% of extrauterine misplacement were diagnosed using x-ray while 58% of intrauterine misplacement were diagnosed using vaginal US. The result of the Fisher's exact test showed a significant difference (p=0.043) in the rate of diagnosis for intrauterine and extrauterine misplacement of IUDs. Also, the results of multi-variable analysis performed for logistical regression analysis showed that intrauterine misplacement occurred 1.23 times more frequently than extrauterine misplacement. Conclusion : Further studies are required on a broader patient population, on more types of IUDs and with time variables taken into account. Despite more research, prevention of complications such as misplacement remains the most appealing situation, being influenced by such factors as technical skill of the physician inserting the IUD, appropriate duration of insertion and proper patient education.