Document Detail


Timing of copper intrauterine device insertion after medical abortion: a randomized controlled trial.
MedLine Citation:
PMID:  21860292     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: : To compare intrauterine device (IUD) use at 6 months in women randomized to receive an intrauterine copper contraceptive 1 week compared with 1 month after medical abortion.
METHODS: : We recruited women undergoing medical abortion with mifepristone and misoprostol and choosing the copper IUD for contraception. We randomly assigned participants to "immediate" insertion 1 week after mifepristone or "delayed" insertion 4-6 weeks later. We followed rates of IUD insertion, 6-month utilization, expulsion, removal, and pregnancy. Participants recorded bleeding in a diary for 4 weeks.
RESULTS: : We randomized 156 participants. We inserted an IUD in 97% of participants in the immediate group and 76% in the delayed group (P<.001). At 6 months, 69% of participants in the immediate group used the IUD compared with 60% in the delayed group (P=.24). Expulsion rates were comparable; 12% (8 of 69) in the immediate group compared with 11% (7 of 65) in the delayed group. Removals occurred in 14% (10 of 69) of immediate and 8% (5 of 65) of delayed group participants (P=.21). Four pregnancies occurred in delayed group participants who did not return for IUD insertion (P=.09). The immediate and delayed groups reported a median of 20 and 19 bleeding or spotting days, respectively (P=.15). We detected no cases of serious infection, uterine perforation, or hemorrhage.
CONCLUSION: : Immediate insertion increased uptake of the IUD without increasing expulsions or bleeding.
CLINICAL TRIAL REGISTRATION: : Clinicaltrials.gov, www.clinialtrials.gov, NCT00737178.
LEVEL OF EVIDENCE: : I.
Authors:
Noa'a Shimoni; Anne Davis; Maria Elena Ramos; Linette Rosario; Carolyn Westhoff
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  118     ISSN:  1873-233X     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  623-8     Citation Subset:  AIM; IM    
Affiliation:
From the Columbia University Department of Obstetrics and Gynecology and New York Presbyterian Hospital, New York, New York.
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