Post-abortion insertion of frameless copper IUDs: A comparison of early expulsion rates of IUDs inserted immediately post-abortion or at unrelated times.
ESC Congress Library. Wiebe E. 05/28/14; 50562; A-147 Disclosure(s): I have received information and devices from Contrel but no money.
Ellen Wiebe
Ellen Wiebe
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Abstract
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 OBJECTIVES: The purpose of this study was to compare the early expulsion rates and other complications in frameless copper IUDs (GyneFix Viz) inserted immediately after first trimester surgical abortions to those inserted into women who were not having abortions. Other studies with other IUDs have found higher early expulsion rates with immediate insertion but fewer unintended pregnancies in the following year compared with women who planned later insertions.


METHODS: This was a retrospective chart review of women who had IUDs inserted by five experienced physicians in two clinics between February and October of 2013. At a follow-up visit 6-8 weeks post-insertion, ultrasound and pelvic examinations were performed. Women who did not come in for the follow-up visit were contacted by phone or email. We compared rates of expulsion, infection, perforation, pregnancy and removal.


RESULTS: There were 152 women who had the IUDs inserted post-abortion and 331 who had insertions unrelated to abortion. There were follow-up data available on 377 women (87.3%); one clinic had 93.6% and the other 62.0% follow-ups. The two groups were similar with respect to mean age (28.0 vs 29.1 years) and history of dysmenorrhea (worst period pain score 5.2/10 vs 5.2/10). The women in the post abortion group were more likely to have had vaginal births (33.6% vs 10.4%).  There were no significant differences with respect to expulsion rates or other complications. The post abortion group had two expulsions (2.0%), two pregnancies (2.0%), three removals (3.0%) and no perforations or infections. The unrelated group had four expulsions (1.4%), four removals (1.4%), two perforations (0.7%) and no infections or pregnancies. One removal was in a woman who wanted to get pregnant, one because she didn't like the idea of a foreign body in her uterus and the others for pain and bleeding. Both women who had perforations had the IUDs removed with a laparoscope and had no further complications.


CONCLUSIONS: Complications rates are so low after IUD insertion that over 2000 subjects in each group would be required to compare rates of expulsion with a power of .80 and α of .05. This study with only 152 women in the post abortion group gives us some reassurance that frameless copper IUDs can be a good choice for insertions immediately post abortion.

 OBJECTIVES: The purpose of this study was to compare the early expulsion rates and other complications in frameless copper IUDs (GyneFix Viz) inserted immediately after first trimester surgical abortions to those inserted into women who were not having abortions. Other studies with other IUDs have found higher early expulsion rates with immediate insertion but fewer unintended pregnancies in the following year compared with women who planned later insertions.


METHODS: This was a retrospective chart review of women who had IUDs inserted by five experienced physicians in two clinics between February and October of 2013. At a follow-up visit 6-8 weeks post-insertion, ultrasound and pelvic examinations were performed. Women who did not come in for the follow-up visit were contacted by phone or email. We compared rates of expulsion, infection, perforation, pregnancy and removal.


RESULTS: There were 152 women who had the IUDs inserted post-abortion and 331 who had insertions unrelated to abortion. There were follow-up data available on 377 women (87.3%); one clinic had 93.6% and the other 62.0% follow-ups. The two groups were similar with respect to mean age (28.0 vs 29.1 years) and history of dysmenorrhea (worst period pain score 5.2/10 vs 5.2/10). The women in the post abortion group were more likely to have had vaginal births (33.6% vs 10.4%).  There were no significant differences with respect to expulsion rates or other complications. The post abortion group had two expulsions (2.0%), two pregnancies (2.0%), three removals (3.0%) and no perforations or infections. The unrelated group had four expulsions (1.4%), four removals (1.4%), two perforations (0.7%) and no infections or pregnancies. One removal was in a woman who wanted to get pregnant, one because she didn't like the idea of a foreign body in her uterus and the others for pain and bleeding. Both women who had perforations had the IUDs removed with a laparoscope and had no further complications.


CONCLUSIONS: Complications rates are so low after IUD insertion that over 2000 subjects in each group would be required to compare rates of expulsion with a power of .80 and α of .05. This study with only 152 women in the post abortion group gives us some reassurance that frameless copper IUDs can be a good choice for insertions immediately post abortion.

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