Second-trimester spontaneous abortion, the IUD, and infection

Abstract

Nineteen cases of spontaneous second-trimester abortion associated with the intrauterine device (IUD) are reviewed and compared to 30 cases of spontaneous second-trimester abortion not associated with the IUD. Fifteen of the IUD's were Dalkon shields and four were Lippes loops. Sixteen of the 19 IUD-associated abortions began either with prolonged rupture of membranes or signs and symptoms of infection. Infection occurred in 18 or 19 of the cases (95 per cent) but only 30 per cent of the comparison group. Eleven major complications occurred in eight patients in the IUD group but only eight complications occurred among seven patients in the comparison group. It is suggested that when the IUD remains in utero during pregnancy, it may be a causal factor in second-trimester spontaneous abortion, and that intrauterine infection is the distinguishing characteristic of such cases. Mechanisms are suggested by which the IUD might cause infected abortion.