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Failed IUD insertions in community practice: an under-recognized problem?

Amna I Dermish1, David K Turok, Janet C Jacobson

  • 1Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA. amna.dermish@hsc.utah.edu

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|September 18, 2012
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Summary
This summary is machine-generated.

Unsuccessful copper T380A intrauterine device (IUD) insertions for emergency contraception were more common in nulliparous women. This highlights a potential need for additional measures to improve IUD insertion success rates.

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Area of Science:

  • Reproductive Health
  • Contraception
  • Family Planning

Background:

  • Investigated unsuccessful copper T380A intrauterine device (IUD) insertions for emergency contraception (EC).
  • Focused on insertions performed at community family planning clinics in Utah.
  • Examined data from a prospective observational trial.

Purpose of the Study:

  • To describe the rate of unsuccessful copper T380A IUD insertions for EC.
  • To determine the effect of parity on IUD insertion success.
  • To identify potential areas for improving IUD insertion techniques.

Main Methods:

  • Prospective observational trial involving nurse practitioners.
  • Copper T380A IUD insertions for EC.
  • Exact logistic regression models adjusted for practitioner failure rates.
  • Did not utilize adjuvant measures for difficult insertions.

Main Results:

  • Six providers performed 197 IUD insertion attempts.
  • Unsuccessful insertions occurred in 19.6% of nulliparous women and 13.6% of parous women.
  • IUD insertion failure was more likely in nulliparous women (aOR=2.31, p=.09).

Conclusions:

  • High rate of unsuccessful IUD insertions, especially in nulliparous women.
  • Suggests higher insertion failure rates when adjuvant measures are not used.
  • Further investigation needed on adjuvant measures to reduce insertion failures.