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Use of statistical procedure to evaluate intrauterine contraception.

This article compares the Lippes Loop and the Dalkon Shield using a method based on a "log-rank" life table which provides better estimates of the net cumulative probabilities with greater sensitivity to the chi-square test. Records of 1308 patients who had IUDs inserted in a hospital in Guadalajara Mexico between 1973 and 1981 were analyzed. Data on type of device and month and cause of removal or termination were manually processed and tabulated. Results show the cumulative probabilities of interruption for the causes studied to be more consistent with the Lippes loop which showed the same 3 primary causes of interruption namely hemorrhage psychosomatic symptoms and pain at 12 and 93 months. For the Dalkon Shield only hemorrhage was a consistent cause of removal over this time period. No statistically significant differences were found in the expected frequencies of pain pregnancy infection and psychosomatic causes with the 2 devices. The observed frequency of hemorrhage suggested statistical significance of P<0.10. Frequency of removal for pregnancy was 2.3 times greater with the Dalkon Shield than with the Lippes loop. The authors concluded that the principal cause of removal of the 2 devices was hemorrhage. The higher rates of hemorrhage and pregnancy with the Dalkon Shield were responsible for a preference for the Lippes loop but the lower incidence rates reported internationally for more modern devices reinforced the decision to discontinue using them.