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Early IUD insertion after medically induced abortion
Rupali Dewan1,2, Nivedita Bharti1,2, Aditi Mittal1,2
1a Department of Obstetrics and Gynaecology , Vardhman Mahavir Medical College, Guru Gobind Singh Indraprastha University , New Delhi , India.
Summary
Early intrauterine device (IUD) insertion after medical abortion shows high continuation rates, safety, and acceptability, similar to delayed insertion. This supports early IUD use as a viable option for women post-medical abortion.
Area of Science:
- Reproductive Health
- Contraception
- Medical Abortion
Background:
- Limited evidence exists regarding the continuation, safety, and acceptability of immediate intrauterine device (IUD) insertion following medical abortion.
- Evaluating early IUD insertion is crucial for improving postpartum contraception access and outcomes.
Purpose of the Study:
- To compare the clinical outcomes of early versus delayed intrauterine device (IUD) insertion after medical abortion.
- To assess the 6-month continuation rates, safety, and user acceptability of IUDs inserted at different times post-medical abortion.
Main Methods:
- A study involving women undergoing medical abortion (up to 49 days gestation) who opted for Copper T 380A IUD contraception.
- Participants were randomized to either early (5-14 days post-mifepristone) or delayed (3-4 weeks post-mifepristone) IUD insertion.
- Primary outcome was 6-month IUD continuation; secondary outcomes included safety and acceptability.
Main Results:
- No statistically significant difference in 6-month continuation rates between early (76.7%) and delayed (83.3%) IUD insertion groups.
- Similar low rates of IUD expulsion, removals, and rare adverse events were observed in both groups.
- User satisfaction and overall safety profiles were comparable for early and delayed IUD insertion.
Conclusions:
- Early intrauterine device (IUD) insertion following medical abortion is associated with high continuation rates.
- The safety and acceptability of early IUD insertion are comparable to delayed insertion, supporting its clinical utility.
- This study demonstrates that early IUD insertion is a safe and acceptable contraceptive option for women after medical abortion.
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