Intrauterine contraceptive insertion postabortion: a systematic review.

Area of Science:

• Reproductive Health
• Contraception
• Gynecology

Background:

• Evaluating the safety and effectiveness of immediate postabortion intrauterine device (IUD) insertion.
• Assessing evidence for IUD insertion following spontaneous or induced abortion.

Purpose of the Study:

• To review and synthesize evidence on immediate postabortion IUD insertion compared to other contraceptive strategies.
• To analyze safety and effectiveness outcomes, including pain, infection, bleeding, and expulsion.

Main Methods:

• Comprehensive literature search of MEDLINE databases from January 1966 to March 2010.
• Inclusion of peer-reviewed articles in all languages comparing immediate postabortion IUD insertion with various control groups.
• Quality assessment and data abstraction using standardized forms.

Main Results:

• Immediate postabortion IUD insertion showed similar rates of pain, infection, and bleeding compared to no IUD insertion.
• No significant differences in bleeding, pain, expulsions, or pelvic inflammatory disease (PID) were found when compared to insertion at a later time.
• Higher expulsion rates were noted for insertions after second-trimester abortions and later first-trimester abortions compared to early first-trimester abortions.

Conclusions:

• Immediate postabortion IUD insertion is not associated with increased adverse outcomes.
• Expulsion rates are generally low but higher after second-trimester and later first-trimester abortions.
• IUD insertion immediately after abortion is a safe and effective contraceptive option.