IUD Expulsion Risk Greater With Postpartum Insertion

Use of intrauterine device similar six months after delivery in immediate-, delayed-insertion groups

WEDNESDAY, Oct. 27 (HealthDay News) -- Pregnant women who have a levonorgestrel-releasing intrauterine device (IUD) inserted immediately after delivery are much more likely to expel the device in the months after delivery than women who delay insertion, but IUD use six months after delivery is similar in the two groups, according to a study in the November issue of Obstetrics & Gynecology.

Beatrice A. Chen, M.D., of the University of Pittsburgh School of Medicine, and colleagues recruited pregnant women who wanted a levonorgestrel-releasing IUD inserted after their vaginal deliveries. The women were randomly assigned to immediate postplacental IUD insertion or delayed IUD insertion, then followed-up at six to eight weeks, three months, and six months.

The researchers note that 98 percent of women randomized to immediate postplacental IUD insertion received their IUD, compared to 90.2 percent in the delayed IUD insertion group (P = .2). However, IUD expulsion within six months occurred in 24.0 and 4.4 percent of the groups, respectively (P = .008). Expelled IUDs were replaced per the woman's preference, and after six months, IUD use was 84.3 and 76.5 percent in the groups, respectively (P = .32).

"Given the six-month expulsion rate of 24 percent, postplacental IUD insertion may not be practical if expected follow-up rates for delayed IUD insertion are high. If expected follow-up rates for delayed IUD insertion are low, then postplacental IUD insertion will increase use of a highly effective, long-acting contraceptive," the authors write.

Several study authors disclosed being investigators in a prior study of a levonorgestrel IUD. Authors also reported financial ties to pharmaceutical companies.

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Jeff Muise

Jeff Muise

Published on October 27, 2010

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