Early IUD insertion after medically induced abortion

Abstract

Objective: There is insufficient evidence on the continuation, safety and acceptability of immediate insertion of the intrauterine device (IUD) after medical abortion. The objective of the present study was to evaluate clinical outcomes of early IUD insertion, compared with those of delayed IUD insertion, following medical abortion.

Methods: Women undergoing medical abortion with mifepristone and misoprostol up to 49 days’ gestation and opting for Copper T 380A IUD contraception underwent early (5–14 days after mifepristone) or delayed insertion (3–4 weeks after mifepristone). The primary outcome measure was 6 month IUD continuation rate after medical abortion. Secondary outcome measures included user acceptability and safety.

Results: Between October 2015 and October 2016, post-medical abortion IUD insertion was performed in 120 eligible women fulfilling the inclusion and exclusion criteria. There was no statistically significant difference in the continuation rates of the early and delayed IUD insertion groups at 6 months (76.7 versus 83.3%, p = .75). The 6 month IUD expulsion rates were 6.7 and 3.3% in the early and delayed insertion groups, respectively (p = .56). There were 10 (16.7%) removals in the early and eight (13.3%) in the delayed insertion groups (p = .77). Level of satisfaction with postabortal IUD use was comparable in both groups. Adverse events were rare and did not differ significantly between the two groups.

Conclusion: We demonstrated high continuation rates, safety and acceptability of early IUD insertion after medical abortion.

摘要：

目的：药物流产后即时放置宫内节育器 (IUD) 的持续性、安全性和可接受性的证据不足。本研究的目的是评价药物流产后早期放置宫内节育器与延迟放置宫内节育器的临床效果。

方法：对妊娠49天使用米非司酮和米索前列醇进行药物流产的妇女选择铜T 380A IUD早期放置(米非司酮后5-14天)或延迟放置(米非司酮后3-4周)。主要观察指标为药物流产后6个月宫内节育器的延续率。次要指标包括使用者的接受度和安全性。

结果:在2015年10月至2016年10月期间, 120名符合纳入和排除标准的合格妇女进行了药物流产后IUD放置。早期宫内节育器放置组和延迟宫内节育器放置组在6个月时的持续率差异无统计学意义(76.7比83.3%, p = 0.75)。早期组和延迟组6个月IUD脱落率分别为6.7%和3.3% (p =0 .56)。早期放置组取出10例(16.7%), 延迟放置组取出8例(13.3%)(p = 0.77)。两组患者对宫内节育器使用的满意度相当。不良事件很少见, 两组间无显著差异。

结论:我们证实药物流产后早期放置宫内节育器的持续性高, 安全性高, 可接受性好。

Keywords:

• Contraception
• early insertion
• IUD
• post medical abortion

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.