Randomized comparison of levonorgestrel- and copper-releasing intrauterine systems immediately after abortion, with 5 years’ follow-up

Pakarinen, Päivi; Toivonen, Juhani; Luukkainen, Tapani

doi:10.1016/s0010-7824(03)00104-5

Cited by 61 publications

(42 citation statements)

References 19 publications

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“…Although prior studies have demonstrated the safety and efficacy of placing LNG-IUDs immediately after either firstor second-trimester abortion [6,10,11], a randomized comparison of immediate versus delayed insertion of the LNG-IUD after D&E has not been reported. The purpose of this study was to assess the 6-month usage of the LNG-IUD when placed immediately after second-trimester D&E compared to 3 to 6 weeks later.…”

Section: Introductionmentioning

confidence: 99%

Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Hohmann

Reeves²,

Chen³

et al. 2009

Contraception

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Background: The study was conducted to compare 6-month usage of the levonorgestrel-releasing intrauterine device (LNG-IUD) when placed immediately or 3 to 6 weeks after dilation and evacuation (D&E) procedure. Study Design: We enrolled women undergoing D&E at 15 to 23 weeks of gestation. After completion of the D&E, subjects without contraindications to immediate IUD insertion were randomized to immediate or delayed (3 to 6 weeks later) LNG-IUD insertion. Subjects in the immediate group had the LNG-IUD placed using ultrasound guidance. All subjects returned at 3 to 6 weeks and 8 to 10 weeks after D&E and were contacted by phone at 6 months. Results: Of the 93 subjects enrolled, 88 were randomized. All 44 subjects (100%) randomized to immediate insertion had successful IUD placement, while only 20 (45.5%) of the 44 subjects randomized to delayed insertion returned for IUD placement, all of which were successful [difference 54.5%, 95% confidence interval (CI) 39.8%-69.3%]. Seventeen (38.6%) participants in each group were lost to follow-up. Of subjects contacted at the 6-month follow-up phone call, 23 of 27 women (85.2%) and 17 of 27 women (62.9%) were utilizing the LNG-IUD in the immediate and delayed groups, respectively (difference 22.2%, 95% CI −0.4% to 44.8%). Intrauterine device expulsion occurred in three subjects (6.8%) and one subject (5.0%) in whom the IUD was placed in the immediate and delayed groups, respectively (p=1.0). No significant adverse events occurred. Conclusion: Significantly more participants had the LNG-IUD placed in the immediate insertion group compared with the delayed insertion group. Given the low risk of complications, immediate post-D&E insertion of the LNG-IUD should be offered, especially for populations that may have difficulty returning for follow-up.

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Section: Introductionmentioning

confidence: 99%

Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Hohmann

Reeves²,

Chen³

et al. 2009

Contraception

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“…Bednarek et al also observed expulsions within the first 2 months after both immediate and delayed Cu-IUD or LNG-IUS insertion after uterine aspiration. 14 Pakarinen et al noted a lower pregnancy rate for LNG-IUS compared with Nova-T users (0.8% vs 9.5%, P < 0.0004) at the end of 5 years, 12 and no pregnancies occurred in the present series.…”

Section: Discussionmentioning

confidence: 42%

Comparison of copper intrauterine device with levonorgestrel‐bearing intrauterine system for post‐abortion contraception

Bilgehan

Dilbaz

Karadağ³

et al. 2015

J of Obstet and Gynaecol

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“…This is at variance with the earlier finding from Jos [8] where all the clients who discontinued IUCD had at least one living child. This contraceptive is acceptable to women who did not have children, and surveyed family planning providers around the world have reported some misbeliefs among their clients including the use of IUCD only by older women or women who have had children [22][23][24][25][26]. This was not seen in this study.…”

Section: Anyaka Charles Et Al: Discontinuation Pattern Among Intrautmentioning

confidence: 75%

Discontinuation Pattern Among Intrauterine Contraceptive Device Users at Jos University Teaching Hospital, Jos, Nigeria

Charles¹

2016

JGO

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Abstract:Context: Despite the high uptake of the intrauterine contraceptive device (IUCD), among family planning clients at Jos University Teaching Hospital (JUTH), some users discontinued its use for a variety of reasons. Objectives: To determine the discontinuation rate and factors responsible among IUCD users in the hospital over a 3 year period. Study Design: This was a 3 year retrospective descriptive study of all clients requesting for the removal of intrauterine devices (IUCDs) at the Family Planning clinic Jos University Teaching Hospital, Jos Nigeria. The study period was between January 1 st 2005 and December 31 st 2007. Results: A total of 849 clients were seen during the study period; 393 (46.3%) clients discontinued within 3 years with the highest rate at 1 year 24.2%. All the women were married with 0.8% of the clients been nullipara. The most common reasons for discontinuation were the desire for pregnancy (50.9%), excessive menstrual bleeding (10.4%), vaginal discharge PID (9.0%) and others. The mean age of the clients was 33.6 ± 5.2 years. Conclusion: The discontinuation rate of IUCD in the family planning clinic at Jos University Teaching Hospital is high. More effective counseling may be appropriate for alternative contraceptive methods for this category of clients instead of the IUCD's currently being used. The findings suggest a need for training the care providers to prevent early discontinuation of IUCD among JUTH clients and by addressing the health challenges via proper counseling, effective follow-up and prompt referral in case of complications.

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Randomized comparison of levonorgestrel- and copper-releasing intrauterine systems immediately after abortion, with 5 years’ follow-up

Cited by 61 publications

References 19 publications

Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Immediate versus delayed insertion of the levonorgestrel-releasing intrauterine device following dilation and evacuation: a randomized controlled trial

Comparison of copper intrauterine device with levonorgestrel‐bearing intrauterine system for post‐abortion contraception

Discontinuation Pattern Among Intrauterine Contraceptive Device Users at Jos University Teaching Hospital, Jos, Nigeria

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