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Updated: May 30, 2026

Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
Published on: September 10, 2018
Postpartum insertion of levonorgestrel--intrauterine system at three time periods: a prospective randomized pilot
Joshua D Dahlke1, Eric R Terpstra, Abigail M Ramseyer
1Department of Obstetrics and Gynecology, The Naval Medical Center Portsmouth, VA 23708, USA. joshua.dahlke@med.navy.mil
Background:
The study was conducted to determine the feasibility of levonorgestrel-intrauterine system (LNG-IUS) insertion at three different times postpartum.
Study Design:
From August 2009 to January 2010, all women desiring LNG-IUS for postpartum contraception were offered enrollment into our study and randomized to three insertion times: immediate (within 10 min of placenta delivery), early (10 min to 48 h postpartum) or interval (≥6 weeks postpartum).
Results:
Forty-six women met inclusion criteria and were analyzed. There was no difference in utilization rates at 3 and 6 months between groups (p=.931). Expulsion rates were significantly higher and pain during insertion was significantly lower in the immediate and early groups (p<.001) when compared to the interval group.
Conclusion:
Insertion of LNG-IUS ≤48 h postpartum is feasible in our institution and may be associated with similar utilization at 6 months, increased expulsion rates and decreased pain at insertion when compared to placement after 6 weeks.
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