Document Detail


A pilot clinical trial of ultrasound-guided postplacental insertion of a levonorgestrel intrauterine device.
MedLine Citation:
PMID:  17900440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postplacental intrauterine device (IUD) insertion is a safe, convenient and effective option for postpartum contraception. Few studies involve ultrasound-guided insertion, and none involve the levonorgestrel IUD or take place in the United States. STUDY DESIGN: The study was conducted to assess the safety and feasibility of ultrasound-guided postplacental insertion of the levonorgestrel IUD following vaginal delivery in a U.S. residency program. Levonorgestrel IUDs were inserted under ultrasound guidance within 10 min of placental delivery by hand or using ring forceps. Subjects were examined at 4 and 10 weeks postpartum for evidence of expulsion or infection. RESULTS: Thirty-four subjects were enrolled and 20 received an IUD. Follow-up data are available for 19 subjects over the 10-week follow-up period; 16 subjects returned for the 4-week follow-up, and 14 returned at 10 weeks. Two additional subjects could be contacted by telephone only. At 4 and 10 weeks postpartum, no subjects had evidence of infection. There were two expulsions (2/19, 10.5%) by 10 weeks postpartum. None of the subjects examined had a partial expulsion (intracervical location of the IUD). CONCLUSIONS: In this pilot study, ultrasound-guided postplacental insertion of the levonorgestrel IUD was feasible and not associated with infection. The risk of expulsion was acceptable. Ultrasound-guided postplacental insertion of the levonorgestrel IUD may be an alternative to delayed insertion but warrants further study.
Authors:
Jennifer L Hayes; Carrie Cwiak; Peggy Goedken; Miriam Zieman
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-06
Journal Detail:
Title:  Contraception     Volume:  76     ISSN:  0010-7824     ISO Abbreviation:  Contraception     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-28     Completed Date:  2008-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234361     Medline TA:  Contraception     Country:  United States    
Other Details:
Languages:  eng     Pagination:  292-6     Citation Subset:  IM    
Affiliation:
Department of Gynecology and Obstetrics, Grady Memorial Hospital, Emory University, Atlanta, GA 30303, USA. jhayes@mail.magee.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Contraceptive Agents, Female / administration & dosage
Female
Humans
Infection / etiology
Intrauterine Devices, Medicated / adverse effects*
Levonorgestrel / administration & dosage
Pilot Projects
Postpartum Period*
Ultrasonography, Interventional / adverse effects,  methods*
Uterus / ultrasonography*
Chemical
Reg. No./Substance:
0/Contraceptive Agents, Female; 797-63-7/Levonorgestrel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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