CORRELATION BETWEEN ECTOPIC PREGNANCY AND USE OF INTRAUTERINE DEVICE

Abstract

Introduction: Ectopic pregnancy is the implantation and development of the embryo outside the uterine cavity, predominantly in the fallopian tube, but also in other locations. It is a serious complication associated with high maternal morbidity and mortality in the first trimester, with an incidence of 1% to 2% in industrialized countries and corresponding to 6% to 13% of maternal deaths in this period. Objective: To investigate the correlation between the use of intrauterine devices (IUD) and the incidence of ectopic pregnancy, analyzing the prevalence of this complication in IUD users compared to women who do not use this contraceptive method. Methodology: This is an integrative literature review, with research carried out in the scientific databases PUBMED and BVS from 2019 to 2024, using the Health Sciences Descriptors: “Intrauterine Devices” and “Pregnancy, Ectopic”. The following inclusion criteria will be used: articles available in full for free distribution, national and international articles, with publications in Portuguese, English and Spanish. The exclusion criteria were articles that did not meet the theme, articles with unavailable abstracts and articles repeated in databases. Results and Discussions: Studies conducted with the objective of evaluating the Pearl Index (PI) for the risk of ectopic pregnancy. The research concluded that the absolute risk of ectopic pregnancy for women using some LNG-IUS was low, but the lower the dose, the greater the risk of GE. In contrast, another study included users of levonorgestrel IUDs in doses of 52 mg, 19.5 mg and 13.5 mg. It was concluded that the use of any dosage of levonorgestrel IUD was associated with a significantly higher risk of ectopic pregnancy compared to other hormonal contraceptives, with the risk being highest for the 13.5 mg IUD, even when compared to other dosages. The results suggest that the 19.5 mg levonorgestrel IUD should be preferred to the 13.5 mg IUD. Although the risk of ectopic pregnancy is lower in IUD users compared with those without contraception, if a pregnancy occurs with the IUD in situ, there is a high probability that it will be an ectopic pregnancy. The incidence of ectopic pregnancy in levonorgestrel IUD (LNG-IUS) users ranges from 0.02 to 0.2 per 100 woman-years, while in copper IUD users this rate ranges from 0.1 to 0.8 per 100 woman-years. A comparison based on the hypothesis that women using highly to moderately effective contraceptive methods would have a lower rate of ectopic pregnancy compared with those using no method or only condoms. Final Considerations: Research into the correlation between the use of intrauterine devices (IUDs) and the incidence of ectopic pregnancy highlights not only the importance of rigorous clinical monitoring, but also the need to improve knowledge among both health professionals and users of these devices.