Intrauterine contraception after medical abortion : factors affecting success of early insertion

Show simple item record Pohjoranta, Elina Suhonen, Satu Mentula, Maarit Heikinheimo, Oskari 2019-01-23T22:36:52Z 2021-12-17T22:02:36Z 2017-03
dc.identifier.citation Pohjoranta , E , Suhonen , S , Mentula , M & Heikinheimo , O 2017 , ' Intrauterine contraception after medical abortion : factors affecting success of early insertion ' , Contraception , vol. 95 , no. 3 , pp. 257-262 .
dc.identifier.other PURE: 90340076
dc.identifier.other PURE UUID: b826a4fd-9af4-42a4-a604-b2c6159d9e41
dc.identifier.other WOS: 000410469000007
dc.identifier.other Scopus: 85007211731
dc.description.abstract Objective: To assess the success and factors affecting early intrauterine device (IUD) provision after first trimester medical termination of pregnancy (MTOP). Study design: Subgroup analysis of a randomized contraceptive trial assessing the long-term effects of early provision of intrauterine contraception following abortion. Altogether, 606 women undergoing MTOP were included and followed for 3 months. The intervention group (n=307) was offered an IUD (either the levonorgestrel-releasing intrauterine system or copper-IUD) at a follow-up visit 1-4 weeks after MTOP. The control group (n=299) contacted primary health care for follow-up and contraceptive provision. Adverse events (infections, bleeding, residual tissue and incomplete abortion) were analyzed on intention-to-treat basis and IUD expulsions on per-protocol (PP) basis. Results: In the intervention group, 234 women (76.2%) received the IUD as scheduled, 46 later (altogether 91.2%). In the control group, the corresponding figures were 8 (2.7%) and 64 [altogether 24.1%, Odds ratio (OR) (95% Confidence interval (Cl)) = 32.7 (20.3-52.6)]. Eighty-five (27.7%) women in the intervention group and 38 (12.7%) in the control group received treatment (administration of antibiotics, misoprostol or surgical evacuation) because of presumed adverse event [2.63 (1.72-4.01)], mainly residual tissue. In the control group, 23 (60.5%) of these occurred during the first 2 weeks. IUD expulsion occurred in 12 (5.4%) of the 222 women in the intervention group (PP basis). Conclusions: When provided as part of abortion service, most early insertions following MTOP were performed as planned. The main reason for postponement was overdiagnosis of adverse events suspected at follow-up. The rate of IUD expulsion was similar to that reported previously. Implications: Early insertion following MTOP is safe, and the rate of IUD expulsion is low. Most adverse events possibly delaying IUD insertion occur early. Based on timing of adverse events in the control group, IUD insertion at approximately 2 weeks after completed MTOP seems optimal. (C) 2017 Elsevier Inc. All rights reserved. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Contraception
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Medical abortion
dc.subject Complication
dc.subject Adverse event
dc.subject Intrauterine contraception
dc.subject IUD expulsion
dc.subject IMMEDIATE
dc.subject TERMINATION
dc.subject ULTRASOUND
dc.subject PREGNANCY
dc.subject 3123 Gynaecology and paediatrics
dc.title Intrauterine contraception after medical abortion : factors affecting success of early insertion en
dc.type Article
dc.contributor.organization University of Helsinki
dc.contributor.organization Clinicum
dc.contributor.organization Department of Obstetrics and Gynecology
dc.contributor.organization HUS Gynecology and Obstetrics
dc.description.reviewstatus Peer reviewed
dc.relation.issn 0010-7824
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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