Alyssa Covelli Colwill1, Courtney A Schreiber2, Mary D Sammel3, Sarita Sonalkar4. 1. Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 1000 Courtyard, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: Colwill@ohsu.edu. 2. Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 1000 Courtyard, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: Courtney.schreiber@uphs.upenn.edu. 3. Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 1000 Courtyard, 3400 Spruce Street, Philadelphia, PA 19104, USA; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania Perelman School of Medicine Rm. 605 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. Electronic address: Msammel@mail.med.upenn.edu. 4. Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, 1000 Courtyard, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: Sarita.sonalkar@uphs.upenn.edu.
Abstract
OBJECTIVES: We sought to evaluate the 6-week clinical outcomes (intrauterine device [IUD] retention, recognized expulsions, ability to visualize or palpate strings, and need for ultrasound evaluation) in women who received a TCu380A postplacental IUD (PPIUD) after vaginal (VD) or cesarean delivery (CD). STUDY DESIGN: We conducted a retrospective cohort study to examine the 6-week retention of TCu380A IUDs placed within 10 min of placental delivery in VD (n=137) and CD (n=73). We used Student's t test and Wilcoxon rank sum tests for continuous data and Pearson χ2 test and Fisher's Exact Test for categorical data. RESULTS: Of the 169 women who had follow-up, 151 (89.3%) retained their IUD at 6 weeks (95% CI 84.7%-93.9%). All women who underwent CD retained their IUD at 6 weeks postpartum (56/56), whereas 95/113 (84% [95% CI 76.0%-90.3%]) who underwent VD retained their original IUD (p<.01). Strings were detected more frequently in women who had a VD (93.1% [95% CI 85.6-97.4]) compared to those who delivered by CD (44.2% [95% CI 30.5-58.7]; p<.01). Women who underwent CD had an ultrasound to evaluate IUD location more frequently (42.9% [95% CI 29.7-56.8]) compared to women who underwent VD (13.7% [95% CI 7.5-22.3]; p<.01). CONCLUSION: Women are more likely to retain a PPIUD after CD compared to a VD (p<.01); however, women who have a PPIUD placed after CD are more likely to have nonvisible strings with a pelvic exam (p<.01) and undergo pelvic ultrasound evaluation (p<.01) compared to a PPIUD placed at the time of a VD.
OBJECTIVES: We sought to evaluate the 6-week clinical outcomes (intrauterine device [IUD] retention, recognized expulsions, ability to visualize or palpate strings, and need for ultrasound evaluation) in women who received a TCu380A postplacental IUD (PPIUD) after vaginal (VD) or cesarean delivery (CD). STUDY DESIGN: We conducted a retrospective cohort study to examine the 6-week retention of TCu380A IUDs placed within 10 min of placental delivery in VD (n=137) and CD (n=73). We used Student's t test and Wilcoxon rank sum tests for continuous data and Pearson χ2 test and Fisher's Exact Test for categorical data. RESULTS: Of the 169 women who had follow-up, 151 (89.3%) retained their IUD at 6 weeks (95% CI 84.7%-93.9%). All women who underwent CD retained their IUD at 6 weeks postpartum (56/56), whereas 95/113 (84% [95% CI 76.0%-90.3%]) who underwent VD retained their original IUD (p<.01). Strings were detected more frequently in women who had a VD (93.1% [95% CI 85.6-97.4]) compared to those who delivered by CD (44.2% [95% CI 30.5-58.7]; p<.01). Women who underwent CD had an ultrasound to evaluate IUD location more frequently (42.9% [95% CI 29.7-56.8]) compared to women who underwent VD (13.7% [95% CI 7.5-22.3]; p<.01). CONCLUSION:Women are more likely to retain a PPIUD after CD compared to a VD (p<.01); however, women who have a PPIUD placed after CD are more likely to have nonvisible strings with a pelvic exam (p<.01) and undergo pelvic ultrasound evaluation (p<.01) compared to a PPIUD placed at the time of a VD.
Authors: Elizabeth P Gurney; Sarita Sonalkar; Arden McAllister; Mary D Sammel; Courtney A Schreiber Journal: Am J Obstet Gynecol Date: 2018-06-02 Impact factor: 8.661
Authors: Sarah H Averbach; Yokabed Ermias; Gary Jeng; Kathryn M Curtis; Maura K Whiteman; Erin Berry-Bibee; Denise J Jamieson; Polly A Marchbanks; Naomi K Tepper; Tara C Jatlaoui Journal: Am J Obstet Gynecol Date: 2020-03-03 Impact factor: 8.661