Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation

Cremer, Miriam; Bullard, Kimberley A.; Mosley, Raegan Mc Donald; Weiselberg, Christine; Molaei, Michael; Lerner, Veronica; Alonzo, Todd A.

doi:10.1016/j.contraception.2010.10.005

Cited by 51 publications

(51 citation statements)

References 12 publications

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“…Os resultados deste estudo, onde 61,4% das usuárias tiveram dois ou mais agendamentos no planejamento familiar para revisões periódicas, assim como a satisfação referida por 85% das usuárias, caracterizam uma boa adesão ao método, estando em sintonia com a literatura 20,21 .…”

Section: Discussionunclassified

“…O presente estudo estabeleceu como desfecho entre as variáveis analisadas a adequação da posição do DIU na cavidade uterina, a qual foi comparada com algumas outras, dentre elas, a época de inserção. O pós-parto 14,15 e o pós-abortamento 4,16,17,20 são considerados por alguns estudos como épocas favoráveis para a inserção, devido as pacientes se encontrarem mais motivadas 14 ou em função da dificuldade de acesso aos serviços de planejamento familiar que muitas delas encontram 20 , sendo também uma estratégia para diminuir o número de gestações indesejadas 20,21 . A inserção pós-parto Tabela 3.…”

Section: Discussionunclassified

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Adequação do dispositivo intrauterino pela avaliação ultrassonográfca: inserção pós-parto e pós-abortamento versus inserção durante o ciclo menstrual

Holanda¹,

PessoA²,

Holanda³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Comparar, empregando a ultrassonografia transvaginal, a adequação da posição do dispositivo intrauterino (DIU) na cavidade uterina, em função do período: inserção pós-parto e pós-aborto versus inserção durante o ciclo menstrual. MÉTODOS: Estudo epidemiológico do tipo individuado, observacional e transversal, realizado entre fevereiro e julho de 2013. Foram incluídas 290 mulheres, sendo 205 com inserção no ciclo menstrual e 85 no pós-abortamento/ pós-parto. As variáveis independentes foram: idade, paridade, tempo de uso, época de inserção, número de retornos ao planejamento familiar, satisfação com o método, desejo de continuidade, queixas e complicações. A variável dependente foi a adequação do DIU na cavidade uterina. Para a análise estatística empregou-se o teste do χ 2 , com correção de Pearson, e o teste exato de Fisher, considerando um nível de significância de 5%. RESULTADOS: A idade média foi de 29,4 anos e o tempo médio de uso foi de 2,7 anos; 39,3% das mulheres tiveram queixas associados ao método, sendo a menorragia a mais frequente (44,7%). A satisfação foi de 85%, e 61,4% retornaram duas ou mais vezes para consultas. A faixa etária, a paridade e a posição do útero não se associaram com má adequação do DIU na cavidade uterina (p>0,05). A inserção no ciclo menstrual associou-se mais à posição adequada do DIU do que a inserção pós-parto/pós-abortamento, com significância estatística (p=0,028). CONCLUSÃO: A inserção no pós-parto e pós-abortamento apresentaram piores resultados quanto à adequação do DIU, não sendo observado o mesmo com a faixa etária, a paridade e a posição do útero na cavidade pélvica. Abstract PURPOSE:To compare by transvaginal ultrasound the position of the intrauterine device (IUD) inside the uterine cavity, depending on the time of insertion, postpartum and post-abortion, and during the menstrual cycle. METHODS: Epidemiologic, observational and cross-sectional study carried out between February and July, 2013. A total of 290 women were included, 205 of them with insertion during the menstrual cycle and 85 during the postpartum and post-abortion periods. The independent variables were: age, parity, time of use, insertion time, number of returns to family planning, satisfaction with the method, wish to continue using the device, symptoms and complications. The dependent variable was the adequate position of the IUD inside the uterine cavity. The χ 2 test with Pearson's correction and the Fisher exact test were used for statistical analysis, with the level of significance set at 5%. RESULTS: The average age was 29.4 years and the average time of IUD use was 2.7 years; 39.3% of the women had symptoms associated with the method, the most frequent being menorrhagia (44.7%). The degree of satisfaction was 85% and 61.4% of the women returned two or more times for consultation about family planning. Age, parity and the position of the uterus in the pelvic cavity was not associated with a poor position of the IUD inside the uterine cavity (p>0.05). Insertion during the menstrua...

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Section: Discussionunclassified

Adequação do dispositivo intrauterino pela avaliação ultrassonográfca: inserção pós-parto e pós-abortamento versus inserção durante o ciclo menstrual

Holanda¹,

PessoA²,

Holanda³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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“…Women who had insertion immediately after the abortion were more likely to be using the IUD at 6 months compared to subjects in the delayed group. In the delayed group, 57% failed to return for IUD insertion [7,8]. The investigators however failed to find a significantly decreased pregnancy risk between randomization groups [7].…”

Section: Introductionmentioning

confidence: 99%

“…In the delayed group, 57% failed to return for IUD insertion [7,8]. The investigators however failed to find a significantly decreased pregnancy risk between randomization groups [7].…”

Section: Introductionmentioning

confidence: 99%

“…Eliminating barriers to highly effective contraception is an important step to increasing contraceptive use with the ultimate goal of decreasing unintended pregnancy. Cremer et al [7] examined the usage of the copper T380A IUD in a randomized trial of immediate or delayed (2 to 4 weeks) insertion after an abortion at greater than 12 weeks of gestational age in 159 women. Women who had insertion immediately after the abortion were more likely to be using the IUD at 6 months compared to subjects in the delayed group.…”

Section: Introductionmentioning

confidence: 99%

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Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Hohmann

Reeves²,

Chen³

et al. 2009

Contraception

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Background: The study was conducted to compare 6-month usage of the levonorgestrel-releasing intrauterine device (LNG-IUD) when placed immediately or 3 to 6 weeks after dilation and evacuation (D&E) procedure. Study Design: We enrolled women undergoing D&E at 15 to 23 weeks of gestation. After completion of the D&E, subjects without contraindications to immediate IUD insertion were randomized to immediate or delayed (3 to 6 weeks later) LNG-IUD insertion. Subjects in the immediate group had the LNG-IUD placed using ultrasound guidance. All subjects returned at 3 to 6 weeks and 8 to 10 weeks after D&E and were contacted by phone at 6 months. Results: Of the 93 subjects enrolled, 88 were randomized. All 44 subjects (100%) randomized to immediate insertion had successful IUD placement, while only 20 (45.5%) of the 44 subjects randomized to delayed insertion returned for IUD placement, all of which were successful [difference 54.5%, 95% confidence interval (CI) 39.8%-69.3%]. Seventeen (38.6%) participants in each group were lost to follow-up. Of subjects contacted at the 6-month follow-up phone call, 23 of 27 women (85.2%) and 17 of 27 women (62.9%) were utilizing the LNG-IUD in the immediate and delayed groups, respectively (difference 22.2%, 95% CI −0.4% to 44.8%). Intrauterine device expulsion occurred in three subjects (6.8%) and one subject (5.0%) in whom the IUD was placed in the immediate and delayed groups, respectively (p=1.0). No significant adverse events occurred. Conclusion: Significantly more participants had the LNG-IUD placed in the immediate insertion group compared with the delayed insertion group. Given the low risk of complications, immediate post-D&E insertion of the LNG-IUD should be offered, especially for populations that may have difficulty returning for follow-up.

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Immediate postabortal insertion of intrauterine devices

Okusanya

Oduwole

Effa

2014

Cochrane Database of Systematic Reviews

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Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation

Cited by 51 publications

References 12 publications

Adequação do dispositivo intrauterino pela avaliação ultrassonográfca: inserção pós-parto e pós-abortamento versus inserção durante o ciclo menstrual

Adequação do dispositivo intrauterino pela avaliação ultrassonográfca: inserção pós-parto e pós-abortamento versus inserção durante o ciclo menstrual

Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Immediate postabortal insertion of intrauterine devices

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