Intrauterine Devices Post Abortion: What Matters?
ESC Congress Library. Costa Ribeiro V. 05/28/14; 50593; A-178
V. Costa Ribeiro
V. Costa Ribeiro
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Abstract
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Intrauterine Devices Post Abortion: What Matters?
Costa Ribeiro V.; Machado A.I.; Palma F.; Alves M.J.; Campos A.
Alfredo da Costa Maternity CHLC, Lisbon
Objectives: to compare expulsion rates of intrauterine devices (copper375-IUD and levonorgestrel-IUD) inserted immediately after surgical abortion by electric vacuum aspiration, up to 10 weeks of gestation.
Design and methods: We conducted a retrospective study of women that chose insertion of intrauterine contraception, immediately after surgical abortion by electric vacuum aspiration. The study was performed between January 2010 and December 2012 in Alfredo da Costa Maternity in Lisbon.
Demographic characteristics, obstetrical past, previous contraception and rates of morbidity were compared between Group A (A): women choosing copper375-IUD (n=128; 53.6%) and Group B (B): women choosing levonorgestrel-IUD (n=111; 46.4%).
Statistic significance (p<0.05) was calculated using SPSS 20.0.
Results: The insertion of intrauterine devices was done immediately after surgical abortion by electric vacuum aspiration (EVA) with ultrasound control. The medium gestational age of abortion was similar in both groups (A: 8.0±1.0 weeks versus B: 7.9±0.9 weeks, p=0.725).
In what concerns demographic characteristics there were no differences between women age (A: 31.8±5.9 versus B: 32.4±6.6, p=0.454), marital status or education degree.
Before abortion similar rates of women had no use of contraception (A: 50.7% versus B: 47.7%, p=0.641) and when using a contraceptive method before abortion, barrier methods and oral contraceptives were the most popular between women of both groups (A: 25% barrier methods; 21% oral contraceptives versus B: 24.3% barrier methods, 22.5% oral contraceptives, p=0.641).
When looking to obstetrical historical there were no differences regarding previous abortions (A: 41.4% versus B: 49.5%, p=0.426) or deliveries (A: 88.2% versus B: 93.6%, p=0.150).
There was no statistically significant difference in expulsion rates of IUD, reported during the first year of use, between groups (A: 6.2% versus B: 4.5%, p=0.408), although there was a higher expulsion rate when surgical abortion by electric vacuum aspiration was performed over 9 weeks of gestational age (12.5%, p=0.016).
In both groups there wasn´t any reported case of uterine perforation or infection.
Conclusions: After surgical abortion by electric vacuum aspiration, immediately insertion of IUD has been shown to be a safe and effective form of contraception. In fact, this form of long acting and reversible contraception could be widely implemented to reduce repeated unplanned pregnancies. Our study found no significant difference between copper-IUD and levonorgestrel-IUD expulsion rates, when inserted immediately after surgical abortion by electric vacuum aspiration. Although IUDs have low expulsion rates, when inserted after an abortion over 9 week of gestation, the expulsion rate becomes higher.
Intrauterine Devices Post Abortion: What Matters?
Costa Ribeiro V.; Machado A.I.; Palma F.; Alves M.J.; Campos A.
Alfredo da Costa Maternity CHLC, Lisbon
Objectives: to compare expulsion rates of intrauterine devices (copper375-IUD and levonorgestrel-IUD) inserted immediately after surgical abortion by electric vacuum aspiration, up to 10 weeks of gestation.
Design and methods: We conducted a retrospective study of women that chose insertion of intrauterine contraception, immediately after surgical abortion by electric vacuum aspiration. The study was performed between January 2010 and December 2012 in Alfredo da Costa Maternity in Lisbon.
Demographic characteristics, obstetrical past, previous contraception and rates of morbidity were compared between Group A (A): women choosing copper375-IUD (n=128; 53.6%) and Group B (B): women choosing levonorgestrel-IUD (n=111; 46.4%).
Statistic significance (p<0.05) was calculated using SPSS 20.0.
Results: The insertion of intrauterine devices was done immediately after surgical abortion by electric vacuum aspiration (EVA) with ultrasound control. The medium gestational age of abortion was similar in both groups (A: 8.0±1.0 weeks versus B: 7.9±0.9 weeks, p=0.725).
In what concerns demographic characteristics there were no differences between women age (A: 31.8±5.9 versus B: 32.4±6.6, p=0.454), marital status or education degree.
Before abortion similar rates of women had no use of contraception (A: 50.7% versus B: 47.7%, p=0.641) and when using a contraceptive method before abortion, barrier methods and oral contraceptives were the most popular between women of both groups (A: 25% barrier methods; 21% oral contraceptives versus B: 24.3% barrier methods, 22.5% oral contraceptives, p=0.641).
When looking to obstetrical historical there were no differences regarding previous abortions (A: 41.4% versus B: 49.5%, p=0.426) or deliveries (A: 88.2% versus B: 93.6%, p=0.150).
There was no statistically significant difference in expulsion rates of IUD, reported during the first year of use, between groups (A: 6.2% versus B: 4.5%, p=0.408), although there was a higher expulsion rate when surgical abortion by electric vacuum aspiration was performed over 9 weeks of gestational age (12.5%, p=0.016).
In both groups there wasn´t any reported case of uterine perforation or infection.
Conclusions: After surgical abortion by electric vacuum aspiration, immediately insertion of IUD has been shown to be a safe and effective form of contraception. In fact, this form of long acting and reversible contraception could be widely implemented to reduce repeated unplanned pregnancies. Our study found no significant difference between copper-IUD and levonorgestrel-IUD expulsion rates, when inserted immediately after surgical abortion by electric vacuum aspiration. Although IUDs have low expulsion rates, when inserted after an abortion over 9 week of gestation, the expulsion rate becomes higher.
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