Fast-track vs. delayed insertion of the levonorgestrel-releasing intrauterine system after early medical abortion - a randomized trial

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Korjamo , R , Mentula , M & Heikinheimo , O 2017 , ' Fast-track vs. delayed insertion of the levonorgestrel-releasing intrauterine system after early medical abortion - a randomized trial ' , Contraception , vol. 96 , no. 5 , pp. 344-351 . https://doi.org/10.1016/j.contraception.2017.07.008

Title: Fast-track vs. delayed insertion of the levonorgestrel-releasing intrauterine system after early medical abortion - a randomized trial
Author: Korjamo, Riina; Mentula, Maarit; Heikinheimo, Oskari
Contributor: University of Helsinki, HUS Gynecology and Obstetrics
University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Clinicum
Date: 2017-11
Language: eng
Number of pages: 8
Belongs to series: Contraception
ISSN: 0010-7824
URI: http://hdl.handle.net/10138/298095
Abstract: Objective: To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast-track ( Study design: In this pilot trial, we randomized 108 women at Results: We had follow-up data at 3 months and 1 year for 41 (74.5%) and 37 (69.8%) women in the fast-track group and 31 (56.4%) and 28 (52.8%) women in the delayed group. By 3 months, expulsion occurred in six (12.5%) women after fast-track and one (2.3%) woman after delayed insertion [risk ratio (RR) 5.50, 95% confidence interval (CI) 0.69-43.90]; most (n=5) of these were partial expulsions in the fast track group. By 1 year, expulsion had occurred in seven (14.6%) and five (11.5%) women in the fast-track and delayed groups, respectively (RR 1.28, 95% CI 0.44-3.75). We found no differences in rates of vacuum aspiration, residual tissue, infection and bleeding or bleeding patterns within 3 months of insertion. Conclusion: Fast-track insertion of the LNG 52-mg IUS after medical abortion is feasible but may result in higher expulsion rates compared to delayed insertion. Due to lack of statistical power and high lost-to-follow-up rates, we were unable to fully address this question. (C) 2017 Elsevier Inc. All rights reserved.
Subject: Medically induced abortion
Contraception
Contraceptive devices
Intrauterine devices
REPEAT ABORTION
CONTRACEPTION
IMMEDIATE
DEVICE
TERMINATION
PREGNANCY
SERVICE
1ST
3123 Gynaecology and paediatrics
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