Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion

Goodman, Suzan; Hendlish, Sarah K.; Benedict, C E Agoha; Reeves, Matthew F.; Pera-Floyd, Madeline; Foster-Rosales, Anne

doi:10.1016/j.contraception.2008.03.008

Cited by 73 publications

(49 citation statements)

References 12 publications

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“…There is evidence from the USA that an additional visit required for insertion of intrauterine contraception after abortion is the main factor that deters women from attending 10 12. Although the median waiting time to insertion of 3 weeks could be considered as substantial, this may have been influenced by factors that we could not take account of within the design of the study, such as some women choosing a later date or changing the date of the appointment.…”

Section: Discussionmentioning

confidence: 99%

Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion: Table 1

Cameron

Berugoda²,

Johnstone³

et al. 2012

J Fam Plann Reprod Health Care

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Background A 'fast-track' referral system for intrauterine contraception was established in 2007 between the medical abortion service at the Royal Infi rmary of Edinburgh and the principal family planning clinic (FPC) in Edinburgh. Methods Case note review of women fasttracked for intrauterine contraception after medical abortion between January 2007 and June 2009. Main outcome measures were numbers of women referred, attendance rates, interval to insertion, devices chosen and known complication rates. Results Of the 237 women referred, 126 (53%) attended for intrauterine contraception insertion. Attenders were slightly but signifi cantly older than non-attenders (mean ages of 30 and 27 years, respectively; p=0.003), less likely to live in an area of deprivation (p=0.045) and were signifi cantly more likely to have attended the FPC in the past (p<0.0001). Most attenders (90%; n=113) proceeded to have an intrauterine method inserted; 57% (n=64) chose the levonorgestrel intrauterine system and 43% (n=49) chose a copper intrauterine device. The median interval to insertion was 21 (range 0-54) days. Of those women (n=55) who attended for routine follow-up 6 weeks later (49%), there were four (7.2%) cases of expulsion, two (3.6%) requests for removal and four (7.2%) cases of suspected infection. Conclusions Only half the women fast-tracked for intrauterine contraception actually attended and these tended to be women who were pre-existing clients of the FPC. Consideration should therefore be given to provision of immediate insertion where possible.

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Section: Discussionmentioning

confidence: 99%

Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion: Table 1

Cameron

Berugoda²,

Johnstone³

et al. 2012

J Fam Plann Reprod Health Care

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“…17 A prospective study in Turkey reported an expulsion rate of 70%, whereas Morrison et al noted a trend toward fewer expulsions (5%) over time with post placental IUCD insertion, when the IUDs were placed by experienced clinicians, suggesting that with experience, placement of IUCD post placentally improves. 2,7 The importance of insertion skills has also been highlighted in studies done by Cheng D and Suzan G et al 19,20 Study by Aznar R et al in which high fundal insertion was done immediately after delivery of placenta showed decreased expulsion.…”

Section: Experience Of Providermentioning

confidence: 94%

A study to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT 380A in Indian women at a premier hospital in New Delhi, India

Kumar¹,

Kumar

Aggarwal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The Study was planned to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT380A in Indian women at Safdarjung Hospital New Delhi, after approval was obtained from Institutional Ethical committee.Methods: Study group consisted of 300 women, divided into two groups: Group A and Group B. The data was analysed by using ‘student “t” test/ non-parametric ‘Wilcoxon Mann Whitney’ for quantitative variables to evaluate the safety, efficacy and acceptability.Results: Mean age was 24.99 years (range: 19-35years), All women were married (off which 64% literate) and Mean parity in group A was 1.97 and 2.06 in group B. Mean pain score during intrauterine contraceptive device (IUCD) insertion on visual analogue scale was 2.93 in group A and 3 in group B and was not statistically different. 84% women completed 12 months follow up in group A and 83.33% women in group B. Strings were visible in 74% women in group A and in 34% women in group B at 1 month of IUCD insertion. Visibility of strings increased in successive follow up visits and was visible in >80% of women at the end of one year in the both groups. String visibility after intra-Caesarean insertion was delayed. Fifty one percent (n=77) subjects in group A and 54% (n=81) in group B experienced amenorrhea up to six months. Menorrhagia was reported in 7.33% in group A and women 8.66% in group B at the end of 1 year of follow up. Pain was complained by 26 out of 150 (17.3%) women in group A as compared to 36 out of 150 (24%) women in group B after 1 month of insertion. There was no case of PID in group A whereas there were 3 cases of PID in group B. There was no perforation/trauma and pregnancy in either group.Conclusions: Overall expulsion rate was 13% and removal rate was 5% in our study. Continuation rate was 83.3% in Cu 375 and 80.6% in CuT380A at 12 months. There was no significant difference between the IUCDs regarding the safety, efficacy and complications such as expulsion, bleeding etc.

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“…Use of IUDs has increased in the United States, 1 and recent studies demonstrate that women undergoing suction abortion accept immediate IUD insertion when available. 2,3 Intrauterine device perforation and expulsion rates immediately after first trimester suction abortion are low and comparable to interval insertion. [3][4][5][6] A recent observational study reported a low expulsion rate of 4.1% when women received IUDs an average of 8 days after medical abortion.…”

mentioning

confidence: 85%

Timing of Copper Intrauterine Device Insertion After Medical Abortion

Shimoni

Davis

Ramos

et al. 2011

Obstetrics &Amp; Gynecology

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Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion

Cited by 73 publications

References 12 publications

Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion: Table 1

Assessment of a ‘fast-track’ referral service for intrauterine contraception following early medical abortion: Table 1

A study to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT 380A in Indian women at a premier hospital in New Delhi, India

Timing of Copper Intrauterine Device Insertion After Medical Abortion

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