Immediate versus delayed initiation of the levonorgestrel‐releasing intrauterine system following medical termination of pregnancy – 1 year continuation rates: a randomised controlled trial

Abstract

Immediate LNG-IUS insertion after MTOP results in a higher 1-year continuation compared with delayed insertion.

Contraception after pregnancy

“…A recent study suggested that giving DMPA at the time of misoprostol administration had no effect on ongoing pregnancy rates . A recent randomized controlled trial demonstrated an increased risk of partial expulsion with fast‐track (≤3 days) insertion of the LNG‐IUS compared with insertion 2‐4 weeks after misoprostol administration (expulsion rates 12‐28 vs. 2%‐4%) . However, use of LNG‐IUS was higher and pregnancy rates were lower at 1 year if the device had been inserted immediately .…”

“…34 A recent randomized controlled trial demonstrated an increased risk of partial expulsion with fast-track (≤3 days) insertion of the LNG-IUS compared with insertion 2-4 weeks after misoprostol administration (expulsion rates 12-28 vs. 2%-4%). 30,35 However, use of LNG-IUS was higher and pregnancy rates were lower at 1 year if the device had been inserted immediately. 36 As with IUC insertion immediately after childbirth, from a public health perspective the advantages of immediate IUC insertion after medical abortion (improved uptake and reduced repeat pregnancy rates) appear to outweigh the disadvantage of increased expulsion rates.…”

Re: Immediate versus delayed initiation of the levonorgestrel‐releasing intrauterine system following medical termination of pregnancy – 1‐year continuation rates: a randomised controlled trial

“…1,2 Her ideas to improve this study and suggestions of further analyses were interesting; however, this study was a pragmatic one, evaluating the immediate insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) following medical termination of pregnancy (MTOP). The details of care were carried out according to the Finnish national guideline on MTOP.…”

“…1 Pregnancyrelated complications and subsequent adverse outcomes after specific drug dosage(s) are emerging as a major public problem in the field of maternal-fetal medicine globally. 2 The overall quality of the present study was impressive, with well-defined and stringent inclusion and exclusion criteria for the enrollment of eligible subjects during a specific timeline, thereby enhancing the reliability of the findings/data generated by assessment(s) of the main outcomes, viz.…”

Authors' reply re: Immediate versus delayed initiation of the levonorgestrel‐releasing intrauterine system following medical termination of pregnancy – 1‐year continuation rates: a randomised controlled trial

“…We wish to thank Dr Saumya Pandey for her interest as well as for her kind words on our study . Her ideas to improve this study and suggestions of further analyses were interesting; however, this study was a pragmatic one, evaluating the immediate insertion of the levonorgestrel‐releasing intrauterine system (LNG‐IUS) following medical termination of pregnancy (MTOP).…”