Immediate postpartum insertion: performance of the Nova-T-PP and randomized comparison with the Nova-T

Abstract

Clinical evaluation of the Postpartum Nova-T or Nova-T-PP (a Nova-T IUD adapted for postpartum insertion) was based on 412 insertions and showed that this model--besides being effective and safe--had a low expulsion rate (7.2% at 1 year). To prove that the Nova-T-PP's low expulsion rate is indeed the result of its special design, a randomized trial was conducted to compare the Nova-T-PP with the parent model (Nova-T) when inserted within 10 minutes of delivery of the placenta. The result of this study (408 insertions, 203 of them Nova-T) indicate that there is no significant difference in expulsion rate between the two IUD models, suggesting that the addition of two extra arms to the original Nova-T model does not improve the retention of the adapted IUD model.

Systematic Review of the Literature on Postpartum Care: Selected Contraception Methods, Postpartum Papanicolaou Test, and Rubella Immunization

“…Three of 6 trials (4–6) scored 2 on the 5‐point Jadad scale (12), and 3 trials scored 3 (2,3,7). The randomization method was unclear in 2 trials, and no study was double‐blinded.…”

“…After interval insertion, the ML Cu 250 was significantly better retained, and the T Cu 200 caused significantly less pain and bleeding. Three trials assessed infection rates postinsertion (2,4,5). However, there were too few cases of infection to allow meaningful comparison between different IUDs (4 cases among all 3 trials).…”

“…Evidence: No trial examined immediate versus delayed insertion of an IUD in a head‐to‐head comparison. In the study by Heikkilä et al, all IUDs were inserted at 6 weeks postpartum (3); Van Kets et al inserted all IUDs immediately postpartum (2). Although Thiery et al, in their 1980 study, included both immediate postpartum and interval insertion, the timing of insertion, its efficacy, and side effect profiles were not directly compared (5).…”

“…Three trials assessed infection rates postinsertion (2,4,5). However, there were too few cases of infection to allow meaningful comparison between different IUDs (4 cases among all 3 trials).…”

Postpartum IUD contraception — a review of an international experience

“…The LEM device [47], the Nova-T-PP [48] and the Delta devices with 'suturing' [21,22,27,31] were developed, but have subsequently been withdrawn because none of these devices markedly improved IUD retainability. On the other hand, researchers like Thiery and colleagues have used copper-bearing devices which are commonly used for interval insertions (such as the TCu380A, TCu200, TCu220, MLCu250 and MLCu375) for IPPIs in their clinics.…”