A retrospective evaluation of the intrauterine device in a patient population in Buenos Aires, Argentina

Jagroep, Sherani R; Pichardo, Margaret S.; Arribas, L Gil; Heredia, Graciela; Coccio, Elina; Palermo, Tia

doi:10.1136/jfprhc-2014-101153

Cited by 2 publications

(2 citation statements)

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“…The rapid expansion of PPCuIUD — in India as well as globally — calls for more evidence on the outcomes of these programs in terms of continuation rates at 1 year and beyond. While global evidence on continuation rates is available for interval intrauterine contraceptive device (IUCD) insertions [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , it is limited for PPCuIUDs. The few studies on PPCuIUD continuation rates are restricted to hospital settings [18] , [19] , [20] , but there is little evidence from any program implemented at scale [21] .…”

Section: Introductionmentioning

confidence: 99%

One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India

et al. 2019

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Objective To evaluate outcomes of a national postpartum (within 48 h of delivery) copper intrauterine device placement (PPCuIUD) program in six “high-focus states” with high unmet family planning need in India. Study design We identified high-volume district hospitals that provided PPCuIUD in six (Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh and Chhattisgarh) Indian states (two per state). Each selected hospital maintained a list of PPCuIUD acceptors with contact phone numbers. We randomly selected 100 women at each site for inclusion in a telephone survey of IUD outcomes at 1 year. Questions regarded IUD expulsion, discontinuation because of symptoms (e.g., pain, bleeding, discharge), discontinuation for other reasons and use of alternative contraception if discontinuation reported. Results We could contact 844 of the 1200 randomly selected women, of whom 673 (79.7%) had postplacental insertion (within 10 min of delivery), while 171 (20.3%) had an early postpartum insertion (between 10 min to 48 h after delivery). Of those contacted, 530 women (62.8%) reported continuing with the method beyond 1 year, 63 (7.5%) reported having an expulsion, 163 (19.3%) reported having removals for associated side effects (bleeding, pain and discharge), and 88 (10.4%) reported having removals for other reasons. After removal or expulsion, almost half of the women (46.5%) did not switch to any other modern contraceptive method. Conclusion PPCuIUD continuation rate at 1 year was 62.8%. Most removals within 1 year were due to associated side effects. Almost half of the women discontinuing PPCuIUD did not switch to an alternative modern contraceptive method. Implications The 1-year continuation rate of PPCuIUD achieved through a large-scale national program in India is satisfactory. The program though needs to address the low uptake of other modern contraceptive methods after discontinuation.

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Section: Introductionmentioning

confidence: 99%

One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India

et al. 2019

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“…Rates of discontinuation due to bleeding were reported in eight studies [ 33 , 35 – 39 , 41 , 42 ]. Rates were < 5% in a large 5-year retrospective study [ 36 ], a cross-sectional study performed in Brazil [ 37 ] and for the smaller Cu-IUDs, VeraCept175 and Mini TT380 Slimline [ 41 , 42 ], whereas in other studies (including for the comparator group in the studies of VerCept175 and MiniTT380) the reported rates for individual studies ranged from 8.5 to 22%. Thus, in most studies, bleeding (and pain) was the reason for discontinuation in over a third of women choosing to have Cu-IUDs removed.…”

Section: Resultsmentioning

confidence: 99%

Discontinuation rates of intrauterine contraception due to unfavourable bleeding: a systematic review

Costescu

Chawla²,

Hughes³

et al. 2022

BMC Women's Health

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Objective Levonorgestrel-releasing intrauterine devices (LNG-IUDs) and copper intrauterine devices (Cu-IUDs) offer long-acting contraception; however, some women may discontinue use within the first year due to bleeding pattern changes, limiting their potential. This systematic literature review investigated whether differences in bleeding profiles influence continuation rates in women in America, Europe and Australia. Methods Searches performed in PubMed and Embase were screened to identify publications describing bleeding patterns and rates of early IUC removal/discontinuation or continuation, descriptions of bleeding patterns, reasons for discontinuation, and patient satisfaction, acceptability and tolerability for LNG-IUDs and Cu-IUDs published between January 2010 and December 2019. The results were further restricted to capture citations related to ‘Humans’ and ‘Females’. The review was limited to studies published from 2010 onwards, as changing attitudes over time mean that results of studies performed before this date may not be generalizable to current practice. Results Forty-eight publications describing 41 studies performed principally in the USA (n = 17) and Europe (n = 13) were identified. Publications describing bleeding patterns in LNG-IUD users (n = 11) consistently observed a reduction in bleeding in most women, whereas two of three studies in Cu-IUD users reported heavy bleeding in approximately 40% of patients. Rates of discontinuation for both devices ranged widely and may be as high as 50% but were lower for LNG-IUDs versus Cu-IUDs. Discontinuation rates due to bleeding were consistently higher for Cu-IUDs versus LNG-IUDs. Conclusions Bleeding is a common reason for discontinuation of Cu-IUDs and LNG-IUDs. The more favourable bleeding pattern observed in LNG-IUD users may be associated with a lower rate of early discontinuation of LNG-IUDs versus Cu-IUDs.

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A retrospective evaluation of the intrauterine device in a patient population in Buenos Aires, Argentina

Abstract: Findings suggest overall good long-term performance with IUD insertion, with minimal complaints or adverse outcomes. These findings may help to support providers serving similar populations in promoting this method.

Cited by 2 publications

References 12 publications

One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India

One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India

Discontinuation rates of intrauterine contraception due to unfavourable bleeding: a systematic review

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