Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study

Müller, Ana Lúcia Letti; Ramos, José Geraldo Lopes; Costa, Sérgio Hofmeister de Almeida Martins; Dias, Ricardo Saraiva; Valério, Edimárlei Gonsales; Hammes, Luciano Serpa; Glitz, Cristina; Zucatto, Ângela Erguy; Vettori, Daniela Vanessa; Magalhães, José Antônio A.

doi:10.1016/j.contraception.2005.03.014

Cited by 42 publications

(17 citation statements)

References 10 publications

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“…Gupta et al also reported lower expulsions after intracaesarean insertions [14]. Letti Müller et al studied expulsion rates of immediate postplacental CuT-380 A insertion by transvaginal sonography and found statistically significant higher expulsions in vaginal insertions than caesarean insertions [17]. …”

Section: Discussionmentioning

confidence: 99%

Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

Hooda

Mann

Nanda

et al. 2016

International Journal of Reproductive Medicine

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Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean). Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables. Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p = 0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p = 0.000). Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.

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Section: Discussionmentioning

confidence: 99%

Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

Hooda

Mann

Nanda

et al. 2016

International Journal of Reproductive Medicine

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“…Expulsion rates of various IUCDs inserted at the time of CS generally seem to be higher than after delayed insertion, with expulsion rates of 0–10.9% at six months following IUCD insertion at CS,7, 10, 11, 12, 13 compared with 3–5% following delayed insertion 14, 15. Less data exist for expulsion of LNG‐IUS inserted at CS, and expulsion rates may be device specific.…”

Section: Introductionmentioning

confidence: 95%

A randomised clinical trial to assess satisfaction with the levonorgestrel‐ releasing intrauterine system inserted at caesarean section compared to postpartum placement

Braniff

Gomez

Müller

2015

Aust NZ J Obst Gynaeco

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BackgroundInsertion of levonorgestrel‐releasing intrauterine system (LNG‐IUS) at caesarean section (CS) provides contraception prior to resumption of ovulation or sexual activity. Patient satisfaction with insertion at CS has not previously been studied.AimsThe aim of this study was to compare patient satisfaction with LNG‐IUS inserted at the time of lower uterine segment CS to six weeks postpartum.Materials and MethodsOpen‐label randomised controlled trial. Women booked for elective CS were randomised to LNG‐IUS insertion either at the time of CS (study group) or at six weeks postpartum (control group). The primary outcome measure was patient satisfaction. Outcomes were measured at six weeks, three months and six months postpartum.ResultsForty‐eight women were randomised into two treatment groups. Twenty‐five women were randomised to have LNG‐IUS inserted at the time of CS, 23 of whom had the planned intervention and two had the LNG‐IUS inserted postpartum. Twenty‐three women were randomised to the control group, four of whom withdrew prior to treatment. The 44 remaining women contributed to data analysis. Patient satisfaction was high and similar in both groups. At six months postpartum, 90.5% of the study group were very satisfied or somewhat satisfied compared with 88.2% of the control group.ConclusionsPatient satisfaction is high with LNG‐IUS insertion at CS and not different to that with delayed insertion. LNG‐IUS insertion may be an option for women who find postpartum contraception difficult to access.

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“…7,8 Existing data suggest that intracesarean delivery (during cesarean delivery) IUD placement may have a lower expulsion risk than placement at time of vaginal delivery. 9-11 The purpose of this study was to compare IUD use at 6 months postpartum among women who underwent intracesarean delivery IUD placement versus women who planned for interval IUD placement 6 or more weeks after delivery.…”

Section: Introductionmentioning

confidence: 99%

Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum

Levi

Stuart

Zerden

et al. 2015

Obstetrics & Gynecology

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Objective To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement versus women who planned for interval IUD placement 6 or more weeks postpartum. Methods In this non-blinded randomized trial women who were undergoing a cesarean and desired an IUD were randomized to intracesarean cesarean delivery or interval IUD placement. The primary outcome was IUD use at 6 months postpartum. A sample size of 112 (56 in each group) was planned to detect a 15% difference in IUD use at 6 months postpartum between groups. Results From March 2012 to June 2014, 172 women were screened and 112 women were randomized into the trial. Baseline characteristics were similar between groups. Data regarding IUD use at 6 months postpartum was available for 98 women, 48 and 50 women in the intracesarean and interval groups, respectively. A larger proportion of the women in the intracesarean group were using an IUD at 6 months postpartum ((40/48), 83%) compared to those in the interval group ((32/50) 64%, relative risk [RR]=1.3, 95% confidence interval [CI]: 1.02, 1.66). Among the 56 women randomized to interval IUD insertion, 22 (39%) of them never received an IUD; 14 (25%) never returned for IUD placement, five (9%) women declined an IUD, and three (5%) had a failed IUD placement. Conclusion IUD placement at the time of cesarean delivery leads to a higher proportion of IUD use at 6 months postpartum when compared to interval IUD placement.

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Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study

Cited by 42 publications

References 10 publications

Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

A randomised clinical trial to assess satisfaction with the levonorgestrel‐ releasing intrauterine system inserted at caesarean section compared to postpartum placement

Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum

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