{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:28:04Z","timestamp":1788449284545,"version":"build-2803163510"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2003,5,20]]},"published-print":{"date-parts":[[2003,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine risk factors affecting the incidence of intrauterine device (IUD) insertion-related complications and failures and, in particular, whether postcoital IUD insertions have a higher incidence of complications than routine IUD insertions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective case notes analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>The study examined 545 case notes of patients having IUD insertions at East Cheshire NHS Trust family planning clinics between 1 October 1997 and 31 December 2000.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>The incidence of complications at insertion, or up to 12 weeks after insertion, was determined and included failed insertion, cervical problems, syncope, bradycardia, convulsions, early perforation and early expulsion. Fourteen potential risk factors were examined to determine the effect on incidence of complications.<\/jats:p>\n                  <jats:p>\n                     <jats:bold>Results.<\/jats:bold> Failed insertions were statistically more likely in women who had never previously had a vaginal delivery and also when a less experienced doctor performed the insertion. Nulliparous women were at statistically increased risk of cervical problems and bradycardia. Cervical problems at insertion also increased significantly with age. Patients who were amenorrhoeic at insertion were more likely to suffer an early IUD expulsion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Of the potential risk factors, nulliparity was the most important. IUD insertion failures and complications were no more common in postcoital than routine IUD insertions. In general, complications were unpredictable, indicating the need for constant vigilance and the inserting doctor being trained and prepared to deal with any complication arising.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1783\/147118903101197854","type":"journal-article","created":{"date-parts":[[2005,3,5]],"date-time":"2005-03-05T01:30:57Z","timestamp":1109986257000},"page":"227-231","source":"Crossref","is-referenced-by-count":52,"title":["Intrauterine device insertion-related complications: can they be predicted?"],"prefix":"10.1136","volume":"29","author":[{"given":"Miranda","family":"Farmer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Webb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2003,10,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/BF01849253","article-title":"Rare events at insertion of an intrauterine device \u2013 a review of an international experience","volume":"3","author":"Chi, I.-C.; Wilkens, L.R.; Siemens, A.J.","year":"1987","unstructured":"Chi I-C, Wilkens LR, Siemens AJ, et al. Rare events at insertion of an intrauterine device \u2013 a review of an international experience. Adv Contracept 1987; 3: 49\u201361.","journal-title":"Adv Contracept"},{"key":"ref_2","first-page":"207","article-title":"Failure to insert an intrauterine device. Contracept Deliv Syst","volume":"4","author":"Chi, I.-C.; Rogers, S.","year":"1983","unstructured":"Chi I-C, Rogers S. Failure to insert an intrauterine device. Contracept Deliv Syst 1983; 4: 207\u2013211."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/0010-7824(87)90089-8","article-title":"Cervical dilatation in interval insertion of an IUD. Who requires it and does it lead to a high expulsion rate?","volume":"36","author":"Chi, I.-C.; Champion, C.B.; Wilkens, L.R.","year":"1987","unstructured":"Chi I-C, Champion CB, Wilkens LR. Cervical dilatation in interval insertion of an IUD. Who requires it and does it lead to a high expulsion rate? Contraception 1987; 36: 403\u2013415.","journal-title":"Contraception"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/0010-7824(86)90083-1","article-title":"Syncope and other vasovagal reactions at interval insertion of Lippes Loop D \u2013 who is most vulnerable?","volume":"33","author":"Chi, I.-C.; Wilkens, L.R.; Siemens, A.J.","year":"1986","unstructured":"Chi I-C, Wilkens LR, Siemens AJ, et al. Syncope and other vasovagal reactions at interval insertion of Lippes Loop D \u2013 who is most vulnerable? Contraception 1986; 33: 179\u2013187.","journal-title":"Contraception"},{"key":"ref_5","first-page":"211","article-title":"Acute neurovascular sequelae of intrauterine device insertion or removal","volume":"11","author":"Conrad, C.C.; Ghazi, M.; Kitay, D.Z.","year":"1973","unstructured":"Conrad CC, Ghazi M, Kitay DZ. Acute neurovascular sequelae of intrauterine device insertion or removal. J Reprod Med 1973; 11: 211\u2013212.","journal-title":"J Reprod Med"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1016\/0002-9378(74)90256-7","article-title":"Electrocardiographic changes during intrauterine contraceptive device insertion","volume":"119","author":"Sherrod, D.B.; Nicholl, W.","year":"1974","unstructured":"Sherrod DB, Nicholl W. Electrocardiographic changes during intrauterine contraceptive device insertion. Am J Obstet Gynecol 1974; 119: 1044\u20131051.","journal-title":"Am J Obstet Gynecol"},{"key":"ref_7","first-page":"92","article-title":"Electrocardiographic changes induced by insertion of an intrauterine device and other uterine manipulations","volume-title":"Fertil Steril","volume":"27","author":"Aznar, R.; Reynoso, L.; Ley, E.","year":"1976","unstructured":"Aznar R, Reynoso L, Ley E, et al. Electrocardiographic changes induced by insertion of an intrauterine device and other uterine manipulations. Fertil Steril 1976; 27: 92\u201396."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1002\/ana.410010322","article-title":"Fits, faints and the IUD","volume":"1","author":"Faden, A.; Spire, J.P.; Faden, R.","year":"1977","unstructured":"Faden A, Spire JP, Faden R. Fits, faints and the IUD. Ann Neurol 1977; 1: 305\u2013306.","journal-title":"Ann Neurol"},{"key":"ref_9","first-page":"123","article-title":"IUD-related uterine perforation: an epidemiologic analysis of a rare event using an international dataset","volume":"5","author":"Chi, I.-C.; Feldblum, P.J.; Rogers, S.M.","year":"1984","unstructured":"Chi I-C, Feldblum PJ, Rogers SM. IUD-related uterine perforation: an epidemiologic analysis of a rare event using an international dataset. Contracept Deliv Syst 1984; 5: 123\u2013130.","journal-title":"Contracept Deliv Syst"},{"key":"ref_10","first-page":"31","article-title":"Risk of uterine perforation among users of intra-uterine devices","volume":"61","author":"Heartwell, S.F.; Schlesselman, S.","year":"1983","unstructured":"Heartwell SF, Schlesselman S. Risk of uterine perforation among users of intra-uterine devices. Obstet Gynecol 1983; 61: 31\u201336.","journal-title":"Obstet Gynecol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0010-7824(98)00029-8","article-title":"Perforations with intrauterine devices \u2013 report from a Swedish survey","volume":"57","author":"Andersson, K.; Ryde-Blomqvist, E.; Lindell, K.","year":"1998","unstructured":"Andersson K, Ryde-Blomqvist E, Lindell K, et al. Perforations with intrauterine devices \u2013 report from a Swedish survey. Contraception 1998; 57: 251\u2013255.","journal-title":"Contraception"},{"key":"ref_12","first-page":"220","article-title":"Intrauterine device termination rates and the menstrual cycle day of insertion","volume":"55","author":"White, M.K.; Ory, H.W.; Rooks, J.B.","year":"1980","unstructured":"White MK, Ory HW, Rooks JB, et al. Intrauterine device termination rates and the menstrual cycle day of insertion. Obstet Gynecol 1980; 55: 220\u2013224.","journal-title":"Obstet Gynecol"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1471-0528.1982.tb15064.x","article-title":"Uterine geometry and IUCD design","volume":"89","author":"Hasson, H.","year":"1982","unstructured":"Hasson H. Uterine geometry and IUCD design. Br J Obstet Gynaecol 1982; 89: 1\u201310.","journal-title":"Br J Obstet Gynaecol"},{"key":"ref_14","article-title":"IUD insertion related complications \u2013 can they be predicted? Dissertation accepted for MFFP","author":"Farmer, M.","year":"2001","unstructured":"Farmer M. IUD insertion related complications \u2013 can they be predicted? Dissertation accepted for MFFP, 2001."}],"container-title":["Journal of Family Planning and Reproductive Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1783\/147118903101197854","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:05:47Z","timestamp":1757099147000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1783\/147118903101197854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,10]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2003,10,1]]},"published-print":{"date-parts":[[2003,10]]}},"alternative-id":["10.1783\/147118903101197854"],"URL":"https:\/\/doi.org\/10.1783\/147118903101197854","relation":{},"ISSN":["1471-1893","2045-2098"],"issn-type":[{"value":"1471-1893","type":"print"},{"value":"2045-2098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,10]]}}}