INTRAUTERINE DEVICE WITH LEVONORGESTREL (MIRENA) LATER TO OBSTETRIC EVENT. EFFECTIVENESS AND TOLERABILITY.
ESC Congress Library. Saravia Cruz P. May 10, 2018; 208181; ESC283
Ms. Pamela Saravia Cruz
Ms. Pamela Saravia Cruz
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Abstract
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OBJECTIVE.- The objective of the study is to know the effectiveness and tolerability  with the use of LNG-IUD after the resolution of an obstetric event; in patients of reproductive age. DESING AND METHODS.-:Cohort, Longitudinal, Observational, prospective, descriptive. RESULTS.- A total of 79 LNG-IUDs were placed in a 3-month period, with follow-up 6 weeks after delivery  during the 1st consultation. The average age of the study population was 25.7 years; with a maximum age of 45 years and the minimum age was 14 years, the patients were grouped by age group, with 18% of patients younger than or equal to 17 years, and 19% of patients with age greater than or equal to at 35 years old. 64.5% of post-delivery LNG-IUD and 34.2% of post-cesarean devices were placed, and 1.3% corresponded to post-abortion placement. During the follow-up of the intrauterine device, 73.4% of the devices were observed in situ, with 6.3% expulsion of the LNG-IUD during the immediate post-partum period secondary to transient hypotonia; and a 20.3% expulsion during the late postpartum period; of which the main cause of withdrawal was due to poor positioning of the device corroborated by vaginal ultrasonography. CONCLUSIONS.- The LARC represent an effective strategy in reducing rates pregnancies. However, the high expulsion rates during the postpartum period; They relate the efficacy to the patient's access in an interval period. The LNG-IUD post obstetric event is a safe contraceptive option, does not increase the risks infection, and allows the benefit of the binomial obtained from breastfeeding. In a systematic review published in 2001, the LNG-IUS was found to reduce menstrual blood loss in women with irregular, heavy bleeding, a significantly greater effect than that of medical regimens such as tranexamic acid and flurbiprofen. The economic benefits derived from preventing invasive and costly procedures such as ablation or hysterectomy to treat irregular, heavy bleeding are potentially high and should be investigated further. Further study of the economic benefits of the LNG-IUS is needed, particularly with respect to the potential impact on budgets for the treatment of bleeding disorders. 
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