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Immediate post-placental IUD insertion: the expulsion problem.

M Thiery, H Van Kets, H Van der Pas

    Contraception
    |April 1, 1985
    PubMed
    Summary
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    Immediate post-placental intrauterine device (IUD) insertion is safe and effective, offering a valuable alternative to interval insertion. Copper IUDs demonstrate comparable effectiveness, though expulsion rates require careful monitoring and follow-up.

    Area of Science:

    • Reproductive Health
    • Contraception
    • Gynecology

    Background:

    • Immediate post-placental insertion of intrauterine devices (IUDs) is an alternative to interval insertion.
    • Evaluating the safety and effectiveness of various IUD models inserted immediately after placental delivery.

    Purpose of the Study:

    • To evaluate the safety and effectiveness of immediate post-placental insertion of non-copper (Lippes Loop D) and copper-bearing IUDs.
    • To compare the performance of different IUD models in the immediate postpartum period.

    Main Methods:

    • Analysis of 2,646 insertions and 55,794 woman-months of experience.
    • Comparison of event rates between Lippes Loop D and various copper IUD models (TCu200, TCu220C, MLCu375, MLCu250, Nova T-PP, DimélysR).

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    Main Results:

    • Immediate post-placental IUD insertion is safe and effective, comparable to interval insertion.
    • Copper IUD models showed comparable effectiveness, superior to Lippes Loop D.
    • Higher expulsion rates observed with immediate postpartum insertion, particularly for Lippes Loop D, necessitating follow-up.

    Conclusions:

    • Immediate post-placental IUD insertion is a safe and effective contraceptive method.
    • Copper IUDs are recommended over Lippes Loop D for immediate postpartum insertion due to lower expulsion risks.
    • Mandatory follow-up during the first trimester is crucial for optimizing effectiveness and managing expulsion risks.