Immediate postplacental insertion of the intrauterine device: A review of Chinese and the world's experiences

Abstract

The postpartum period is an ideal time to begin contraception, as women are more highly motivated to adopt contraception at this time and it is convenient for both patients and service providers. For intrauterine device (IUD) contraception, this period offers other advantages, such as ease of insertion and minimal adverse impacts on breastfeeding. Among early studies, most postpartum insertions were performed anywhere from a few hours to seven days or more after delivery, and retention of the IUD in the uterus was poor. Since the 1970s, immediate postplacental insertion (IPPI), i.e., IUD insertion performed within 10 minutes after placental delivery, has been advocated, and fairly, low expulsion rates have been reported. Up to now, IPPI has not been widely accepted in clinics because its expulsion rate still appears to be higher than that of interval insertion. In order to further study IPPI and perfect this contraceptive technique, it is essential to comprehensively review IPPI results and compare the Chinese experience with that of the rest of the world.

Comparative evaluation of Postpartum versus post MTP insertion of intrauterine contraceptive device

“…Xu JX et al 19 noted higher expulsion rates 22.4% in non-breast feeding women as compared to 11.9% in breast feeding women.…”

Education Status of Husband and Wife and its Influence on Acceptance of Contraception

“…2,3 The postpartum period is potentially an ideal time to begin contraception as women are more strongly motivated to do so at this time, which also has the advantage of being convenient for both patients and health-care providers. 4 Acceptance of family planning is influenced by a variety of interrelated factors such as age at marriage, education, economic status, religion, number of living children etc. Education status of husband and wife may affect the acceptance of contraception.…”

Kemudahan dan Efek Samping Penggunaan Inserter Baru (R_inserter) Untuk Pemasangan IUD CuT-380A Pascasalin

“…Sehingga angka kelangsungan pemakaian selama 3 bulan sebesar 89,4% dan 6 bulan sebesar 86,6%. penelitian yakni angka kehamilan kurang dari 3 dan angka ekspulsi kurang dari 20 per 100 women-years [4,12] .…”

“…Dalam sebuah penelitian di China, Xu dkk , menunjukkan bahwa tidak ada perbedaan dalam angka ekspulsi antara pemasangan IUD menggunakan tangan dibanding menggunakan klem cincin. Angka ekspulsi dari kedua cara tersebut mencapai10,8% (95% CI 8,02 -13,76) pada pemasangan dengan tangan dan 11,8% (95% CI 8,31 -14,24) [4,5] . Sebuah review oleh WHO menunjukkan bahwa ekspulsi memang menjadi perhatian utama karena angkanya yang relatif tinggi yakni antara 6% sampai 44,1% pada kurun waktu pemakaian 6 sampai 36 bulan [3] .…”