Copper-bearing intrauterine devices are being increasingly used for contraception. A growing number of pregnancies, which may subsequently carry to term, are therefore being exposed to high levels of copper at the critical period of organogenesis, with risk of possible teratogenesis. Two cases of anencephaly occurring in association with these devices are reported.
PIP: The possible toxic implications of copper from copper-bearing IUDs in congenital abnormalities of fetuses conceived with the IUD in situ are supported by the presentation of 2 such case histories. In Case 1, the woman became pregnant with a copper IUD in place and the woman delivered, after labor induction at 39 weeks, an anencephalic, stillborn, infant male. Case 2 also had a copper IUD inserted 16 months prior to conception. At 7 weeks from the last menstrual period, an ultrascan was performed because of excessive bleeding, and the IUD was visualized posterior to the sac. At 30 weeks of gestation, the labor was induced and the patient delivered an anencephalic infant. The possible teratogenic effect of copper should be discussed with women who conceive with a copper device in place and elect to continue the pregnancy.