Analysis Of Correlative Factors Affecting Ectopic Of Intrauterine Contraceptive Device

Research background:Intrauterine device(IUD)is a reversible long-acting contraceptive tool.About 70%of women of childbearing age in China use IUD for contraception.Although theshape and material of IUD have been continuously improved with the progress of science and technology,ectopic IUD is still one of the serious complications of its use.The ectopic IUD can lead to abnormal uterine bleeding,pelvic infection,uterineperforation,damage to other organs around it,damage to female reproductive health,and endanger the life of patients in severe cases,which limits the promotion anduse of IUD.The aim of this study was to find out the related risk factors of IUD ectopic in recent years,so as to ensure the safe use of IUD in clinic.Purpose of research:A retrospective study was conducted to explore the related risk factors of ectopic IUD in the past 6 years,and to develop feasible preventive measures to provide a reference basis for guiding the safe use of IUD in clinic.Research method:1.A total of 110 ectopic IUD patients who met the inclusion and exclusion criteria in the second Hospital of Shanxi Medical University from January 2015 to November 2020were selected,and no ectopic patients occurred in the same period.The required clinical data were obtained by looking at the patients’electronic medical records and telephone return visits,and the clinical data were analyzed retrospectively.2.Univariate analysis was used to compare the relevant data of the two groups,including general data,past medical history and the use of IUD.General data include:age,menopausal status,times of pregnancy,times of parturition,times of abortion,location of uterus,regular reexamination.Past medical history includes cesarean section,artificial abortion,and history of uterine leiomyoma.IUD usage includes:IUD type,timing of IUD placement,duration of IUD placement,placement times.3.The results of univariate analysis were included in multi-factor Logistic regression analysis to find out the independent risk factors of IUD ectopic.Statistical method:SPSS25.0 statistical software was used to analyze the data.The counting data(including menopausal state,cesarean section history,artificial abortion history,complicated uterine myoma history,IUD type,timing of IUD placement,duration of IUD placement,uterine position,regular review)statistical description was expressed by frequency and percentage,andχ~2test was used for comparison between groups.The measurement data(Age)accord with the normal distribution,and the statistical description is expressed by the mean±standard deviation((?)±s),which does not accord with the normal distribution(number of pregnancies,parturients,miscarriagesand implants).The statistical description is expressed by the median(quartile),and the rank sum test is used for the comparison between groups.Multivariate Logistic regression was used to analyze the multivariate analysis.The difference was statistically significant(P<0.05).Research results:1.There were 110 patients in the ectopic group,including 86 cases of partial ectopic,10 cases of complete ectopic,and 14 cases of extrauterine ectopic.2.The general data included age(P=0.468),menopausal status(P=0.089),pregnancy(P=0.334),parity(P=0.817),abortion(P=0.057),uterine position(P=0.828)and regular reexamination(P=0.573),there was no significant difference between the two groups.3.Univariate analysis of past medical history:the history of induced abortion(χ~2=4.579,P=0.032)were significantly different between the two groups.There was no significant difference in the history of cesarean section(χ~2=0.251,P=0.616)and history of uterine leiomyoma(χ~2=0.305,P=0.581)between the two groups.4.Univariate analysis of IUD use showed that there were significant differences in the timing of IUD placement(χ~2=7.257,P=0.027)and the duration of IUD placement(χ~2=8.429,P=0.015).Make a pairwise comparison of the placement timing of the IUD within the group:there was a significant difference in the incidence of ectopic placement between clean menstruation and lactation(χ~2=5.588,P=0.018),and between clean menstruation and induced abortion(χ~2=5.262,P=0.022).There was no significant difference in the incidence of ectopic placement between lactation and induced abortion(χ~2=0.024,P=0.876).Make a pairwise comparison of the length of time the IUD has been placed in the group:there was no significant difference between<5 years and 5-10 years(χ~2=2.672,P=0.102),the incidence of ectopic was significantly higher in patients with>10years than that in<5 years(χ~2=8.429,P=0.004),and the incidence of ectopia in>10 years was higher than that in 5-10 years,and the difference was statistically significant(χ~2=4.090,P=0.043).There was no significant difference between IUD type(χ~2=2.463,P=0.117)and the number of times of implanting devices(P=0.430).5.Multivariate analysis of IUD ectopia:The history of induced abortion(P=0.031),the duration of IUD placement(P=0.032)and the timing of IUD placement(P=0.028)were independent risk factors for the occurrence of ectopic IUD.The risk of IUD ectopic in patients with a history of induced abortion was 2.177 times higher than that in patients without a history of induced abortion(OR=2.177 95%CI=1.072～4.422).The risk of ectopic occurrence after IUD placement of>for 10 years was 3.955 times of that after IUD placement of less than 5 years(OR=3.955 95%CI=1.408～11.110).The risk of ectopic IUD placement during lactation was 2.522 times that of placement after menstruation(OR=2.522 95%CI=1.263～5.037).Conclusion:1.The history of induced abortion is an independent risk factor affecting the occurrence of ectopic IUD.Women of childbearing age who have no fertility requirements should choose effective contraceptive measures to reduce the occurrence of unwanted pregnancy and induced abortion.2.The duration of IUD placement was an independent risk factor affecting theoccurrence of IUD ectopic location.The IUD should be removed or replaced in time according to the age of the IUD.3.The timing of IUD placement is an independent risk factor affecting the occurrence of IUD ectopic location.Try not to place during lactation.