Expulsion rate of intrauterine device: mediate vs. immediate puerperium period
Journal Title: Journal of the Turkish-German Gynecological Association - Year 2020, Vol 21, Issue 3
Abstract
Objective: To evaluate the rate of expulsion of intrauterine device (IUD) inserted during the immediate and mediate puerperium. To evaluate whether the type of delivery is a predictor of expulsion of the IUD when inserted in the puerperium period. Material and Methods: This was a prospective observational study. Patients whose IUD (TCU-380 copper) was placed during the puerperal period were divided in two groups according to the time of placement: immediate and mediate puerperium. The decision regarding the time of IUD insertion was made in a non-randomized manner. Analysis was performed using chi-square, Mann-Whitney U, and Spearman’s correlation tests and logistic regression analysis. Results: The total rate of IUD expulsions was 28.8% (49/170). There was no significant association between the occurrence of expulsion and the timing of IUD insertion (immediate vs mediate puerperium; 26.6% vs 34.78%, p=0.296). Among patients experiencing expulsion, 79.6% (39/49) underwent insertion after vaginal delivery and 20.4% (10/49) during cesarean section (CS). The type of delivery was a significant predictor for IUD expulsion (p<0.0001). Vaginal delivery was fourfold more likely to be associated with IUD expulsion inserted in the puerperal period than CS (odds ratio: 4.23, 95% confidence interval: 1.94-9.25). There was no significant correlation between the period between IUD insertion and the diagnosis of expulsion in regard to number of pregnancies (r=-0.160, p=0.271) or gestational age at delivery (r=-0.058, p=0.939). Conclusion: Vaginal delivery was the most prevalent type of delivery in patients who underwent IUD insertion during the immediate and mediate puerperium. The risk of IUD expulsion after vaginal delivery was greater than CS.
Authors and Affiliations
Juliano Terra Hochmuller, Karina Souza Lopes, Cristina Aparecida Falbo Guazzelli, Mariana Kefalas Oliveira Gomes, Edward Araujo Júnior, Alberto Borges Peixoto
Keywords
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- EP ID EP688810
- DOI 10.4274/jtgga.galenos.2020.2020.0037
- Views 161
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