TY - JOUR
T1 - Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation
AU - Cremer, Miriam
AU - Bullard, Kimberley A.
AU - Mosley, Raegan Mc Donald
AU - Weiselberg, Christine
AU - Molaei, Michael
AU - Lerner, Veronica
AU - Alonzo, Todd A.
N1 - Funding Information:
Funding for this study was provided by a Berlex Foundation Grant. Copper T 380A intrauterine devices were donated by Duramed Research Incorporated (Bala Cynwyd, PA, USA).
PY - 2011/6
Y1 - 2011/6
N2 - Background: The intrauterine device (IUD) is a safe, effective, well-tolerated form of contraception. Immediate placement after second-trimester abortion could increase high-tier contraception use in women who are at high risk for unintended pregnancy. Study Design: This randomized controlled trial compared immediate vs. delayed placement of Copper T380A IUD insertion 2-4 weeks after second trimester abortion. The primary outcome analyzed was the percentage of women using a copper T380A IUD 6 months after surgery. Secondary outcomes were percentage of subjects using other high or middle tier contraception, expulsion, infection and repeat pregnancy rates as well as IUD satisfaction. In expectation of a high loss to follow-up at 6 months, 215 subjects were enrolled for a desired sample size of 158 subjects. Results: Contraceptive and pregnancy status at 6 months was known for 159 of 215 subjects. Women randomized to immediate insertion were significantly more likely to have an IUD at 6 months compared to delayed (81.7% vs. 28.4%, p=.003). Relative risk was 11.2 (95% CI 5-26). There were 8 (5.1%) of 159 repeat unintended pregnancies. No women had a repeat pregnancy that had an IUD placed in the operating room. In the as-treated analysis, 64 women in the immediate group received the IUD and 0% had a repeat pregnancy. Of the remaining 95 women, 8 (8.4%) had a repeat pregnancy. This is a statistically significant difference (p=.022). Conclusion: Placing the IUD immediately after the procedure significantly increases the likelihood of use of effective contraception following a second-trimester procedure. Women who have an IUD placed immediately after their procedure may also be less likely to have a subsequent unplanned pregnancy.
AB - Background: The intrauterine device (IUD) is a safe, effective, well-tolerated form of contraception. Immediate placement after second-trimester abortion could increase high-tier contraception use in women who are at high risk for unintended pregnancy. Study Design: This randomized controlled trial compared immediate vs. delayed placement of Copper T380A IUD insertion 2-4 weeks after second trimester abortion. The primary outcome analyzed was the percentage of women using a copper T380A IUD 6 months after surgery. Secondary outcomes were percentage of subjects using other high or middle tier contraception, expulsion, infection and repeat pregnancy rates as well as IUD satisfaction. In expectation of a high loss to follow-up at 6 months, 215 subjects were enrolled for a desired sample size of 158 subjects. Results: Contraceptive and pregnancy status at 6 months was known for 159 of 215 subjects. Women randomized to immediate insertion were significantly more likely to have an IUD at 6 months compared to delayed (81.7% vs. 28.4%, p=.003). Relative risk was 11.2 (95% CI 5-26). There were 8 (5.1%) of 159 repeat unintended pregnancies. No women had a repeat pregnancy that had an IUD placed in the operating room. In the as-treated analysis, 64 women in the immediate group received the IUD and 0% had a repeat pregnancy. Of the remaining 95 women, 8 (8.4%) had a repeat pregnancy. This is a statistically significant difference (p=.022). Conclusion: Placing the IUD immediately after the procedure significantly increases the likelihood of use of effective contraception following a second-trimester procedure. Women who have an IUD placed immediately after their procedure may also be less likely to have a subsequent unplanned pregnancy.
KW - Contraception
KW - IUD insertion
KW - Second trimester abortion
KW - Unplanned pregnancy
UR - http://www.scopus.com/inward/record.url?scp=79955929149&partnerID=8YFLogxK
U2 - 10.1016/j.contraception.2010.10.005
DO - 10.1016/j.contraception.2010.10.005
M3 - Article
C2 - 21570549
AN - SCOPUS:79955929149
SN - 0010-7824
VL - 83
SP - 522
EP - 527
JO - Contraception
JF - Contraception
IS - 6
ER -