Risk Factors for Intrauterine Device Malposition
Objective: To identify risk factors for Intrauterine Device (IUD) malposition on ultrasound and develop a model to predict who may be at risk for IUD malposition. Methods: We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 and July 2017 within a large...
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| Format: | Article |
| Language: | English |
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Levy Library Press
2024-12-01
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| Series: | Journal of Scientific Innovation in Medicine |
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| Online Access: | https://account.journalofscientificinnovationinmedicine.org/index.php/ll-j-jsim/article/view/223 |
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| author | Ann C. Frisse Jay B. Louik Isha A. Kachwala Haotian Wu Nicole Felix Thammatat Vorawandthanachai Karina Avila Nerys C. Benfield |
| author_facet | Ann C. Frisse Jay B. Louik Isha A. Kachwala Haotian Wu Nicole Felix Thammatat Vorawandthanachai Karina Avila Nerys C. Benfield |
| author_sort | Ann C. Frisse |
| collection | DOAJ |
| description | Objective: To identify risk factors for Intrauterine Device (IUD) malposition on ultrasound and develop a model to predict who may be at risk for IUD malposition. Methods: We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 and July 2017 within a large urban medical system. Our primary outcome was IUD malposition. We used Fisher’s Exact Test and Wilcoxon Rank Sum Test to compare clinical characteristics between patients with malpositioned and non-malpositioned IUDs. We then selected variables and applied them to the least absolute shrinkage and selection operator (LASSO), elastic net, and logistic regression models. Results: Of 1,759 ultrasounds demonstrating the presence of an IUD, 436 described IUD malposition of which 150 were described as embedded and 16 were described as perforated. There were no significant differences in clinical characteristics between participants with malpositioned and non-malpositioned IUDs except a 1.2-year difference in mean age. Radiologists, compared to gynecologists, were more likely to describe an IUD as malpositioned (RR = 1.53, 95% CI: 1.21, 1.99). Abnormal uterine bleeding (AUB) as an indication for the ultrasound and fibroids visualized on ultrasound were more common in the malposition group compared to the non-malpositioned group (19.7% compared to 14.9%, p = 0.02 and 21.6% compared to 15.9%, p < 0.01 respectively). No linear combinations of any subset of variables predict the likelihood of having IUD malposition. Conclusion: Participants with IUDs described as malpositioned on ultrasound report were more likely to have their ultrasound interpreted by a radiologist, be 1.2 years younger, have an ultrasound performed for the indication of AUB, and have fibroids mentioned in their report. |
| format | Article |
| id | doaj-art-8616e947a3d240cfae5f5a7a7a75db95 |
| institution | Kabale University |
| issn | 2579-0153 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Levy Library Press |
| record_format | Article |
| series | Journal of Scientific Innovation in Medicine |
| spelling | doaj-art-8616e947a3d240cfae5f5a7a7a75db952025-01-08T08:38:53ZengLevy Library PressJournal of Scientific Innovation in Medicine2579-01532024-12-01715510.29024/jsim.223222Risk Factors for Intrauterine Device MalpositionAnn C. Frisse0https://orcid.org/0000-0002-2935-5505Jay B. Louik1https://orcid.org/0000-0001-6993-9161Isha A. Kachwala2Haotian Wu3Nicole Felix4Thammatat Vorawandthanachai5Karina Avila6Nerys C. Benfield7Department of Obstetrics, Gynecology, and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY, 10461; Department of Obstetrics and Gynecology, Westchester Medical Center, 19 Bradhurst Ave, Hawthorne, NYAlbert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1468 Madison Ave, New York, NY, 10029Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461; Department of Pediatrics, Albert Einstein College of Medicine/Montefiore Medical Center, 3411 Wayne Ave, Bronx, NY, 10467Department of Environmental Health Sciences, Mailman School of Public Health at Columbia University, 722 West 168th Street, New York, NY, 10032Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461; Department of Pediatrics, Brown University, 593 Eddy Street, Providence, RI, 02903Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461; Department of Obstetrics and Gynecology, Maimonides Medical Center, 4802 Tenth Avenue, Brooklyn, NY, 11219Department of Obstetrics, Gynecology, and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY, 10461; Department of Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, 1300 Morris Park Ave, Bronx, NY, 10461Department of Obstetrics, Gynecology, and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY, 10461; Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, 1825 Fourth St, San Francisco, CA, 94158Objective: To identify risk factors for Intrauterine Device (IUD) malposition on ultrasound and develop a model to predict who may be at risk for IUD malposition. Methods: We performed a retrospective cohort study of IUD users with ultrasounds performed between July 2014 and July 2017 within a large urban medical system. Our primary outcome was IUD malposition. We used Fisher’s Exact Test and Wilcoxon Rank Sum Test to compare clinical characteristics between patients with malpositioned and non-malpositioned IUDs. We then selected variables and applied them to the least absolute shrinkage and selection operator (LASSO), elastic net, and logistic regression models. Results: Of 1,759 ultrasounds demonstrating the presence of an IUD, 436 described IUD malposition of which 150 were described as embedded and 16 were described as perforated. There were no significant differences in clinical characteristics between participants with malpositioned and non-malpositioned IUDs except a 1.2-year difference in mean age. Radiologists, compared to gynecologists, were more likely to describe an IUD as malpositioned (RR = 1.53, 95% CI: 1.21, 1.99). Abnormal uterine bleeding (AUB) as an indication for the ultrasound and fibroids visualized on ultrasound were more common in the malposition group compared to the non-malpositioned group (19.7% compared to 14.9%, p = 0.02 and 21.6% compared to 15.9%, p < 0.01 respectively). No linear combinations of any subset of variables predict the likelihood of having IUD malposition. Conclusion: Participants with IUDs described as malpositioned on ultrasound report were more likely to have their ultrasound interpreted by a radiologist, be 1.2 years younger, have an ultrasound performed for the indication of AUB, and have fibroids mentioned in their report.https://account.journalofscientificinnovationinmedicine.org/index.php/ll-j-jsim/article/view/223ultrasoundintrauterine devicecontraceptionmalposition |
| spellingShingle | Ann C. Frisse Jay B. Louik Isha A. Kachwala Haotian Wu Nicole Felix Thammatat Vorawandthanachai Karina Avila Nerys C. Benfield Risk Factors for Intrauterine Device Malposition Journal of Scientific Innovation in Medicine ultrasound intrauterine device contraception malposition |
| title | Risk Factors for Intrauterine Device Malposition |
| title_full | Risk Factors for Intrauterine Device Malposition |
| title_fullStr | Risk Factors for Intrauterine Device Malposition |
| title_full_unstemmed | Risk Factors for Intrauterine Device Malposition |
| title_short | Risk Factors for Intrauterine Device Malposition |
| title_sort | risk factors for intrauterine device malposition |
| topic | ultrasound intrauterine device contraception malposition |
| url | https://account.journalofscientificinnovationinmedicine.org/index.php/ll-j-jsim/article/view/223 |
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