At the conclusion of the expert group, removal of IUD CONTRACEPTIVE improves prediction about the outcome of pregnancy, provided that the IUD CONTRACEPTIVE threads are easily detected visually or can be extracted from the cervical canal without any negative consequences, and leaving the IUD CONTRACEPTIVE in place will significantly increase the risk of miscarriage, premature delivery and infection.
The above recommendations were based on evidence-based facts about the use of copper-bearing IUD CONTRACEPTIVE. Also, in the opinion of the Expert Working Group, there are theoretical concerns that the fetus may be exposed to additional risk due to the presence in the intrauterine hormonal component. However, to date it remains unknown whether these fears are justified.
Question in a systematic review
What is the risk of adverse effects when removing the levonorgestrel-containing IUD CONTRACEPTIVE or leaving it in place? Level of Evidence: II-2 deficient, indirect.
References from systematic review
1. Backman T et al. Pregnancy during the use of levonorgestrel intrauterine system. American Journal of Obstetrics and Gynecology, 2004, 190:50-54.
2. Fulcheri E, di Capua E, Ragni N. Pregnancy despite IUD; adverse effects on pregnancy evolution and fetus. Contraception, 2003, 68:35-38.
Key unresolved issues
Is there a negative effect on the fetus due to the presence in the levonorgestrel intrauterine device?
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