THE ASSOCIATION OF INSERTION METHODS ON IMMEDIATE POSTPARTUM INTRAUTERINE DEVICE EXPULSION RATES: A RETROSPECTIVE COHORT STUDY

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110634

EM Perkins, J Federspiel, D Bhattacharya, S de los Reyes

{"title":"THE ASSOCIATION OF INSERTION METHODS ON IMMEDIATE POSTPARTUM INTRAUTERINE DEVICE EXPULSION RATES: A RETROSPECTIVE COHORT STUDY","authors":"EM Perkins, J Federspiel, D Bhattacharya, S de los Reyes","doi":"10.1016/j.contraception.2024.110634","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>We sought to evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within six weeks postpartum.</div></div><div><h3>Methods</h3><div>We performed a retrospective cohort study of patients who had a singleton vaginal delivery and had an immediate ppIUD inserted at Rush University from January 2014 to September 2023. Subjects were excluded if they had a postpartum hemorrhage, no insertion data available, or did not have documentation of postpartum follow up. The primary outcome was rate of expulsion within six weeks postpartum. The rate of expulsion was compared by method of insertion, either using a manual technique versus using ring forceps. Univariable analyses were performed for the association between baseline maternal characteristics and the primary outcome.</div></div><div><h3>Results</h3><div>A total of 219 participants met eligibility with 117 immediate ppIUDs inserted manually and 102 inserted with ring forceps. Baseline maternal demographics were similar across study groups. In unadjusted analysis, expulsion rate in patients who had IUDs placed using ring forceps was significantly higher as compared to manual insertion (30.4% vs 16.2%, p =0.01). After adjusting for factors determined a priori (estimated blood loss, body mass index, GA at delivery, multiparity, type of IUD), ring forceps continued to be significantly more likely to result in expulsion (adjusted OR (aOR) 2.45, CI 1.28-4.90).</div></div><div><h3>Conclusions</h3><div>Insertion of immediate ppIUD with ring forceps was associated with a significantly increased rate of expulsion within six weeks postpartum when compared with manual insertion.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contraception","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0010782424003299","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

We sought to evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within six weeks postpartum.

Methods

We performed a retrospective cohort study of patients who had a singleton vaginal delivery and had an immediate ppIUD inserted at Rush University from January 2014 to September 2023. Subjects were excluded if they had a postpartum hemorrhage, no insertion data available, or did not have documentation of postpartum follow up. The primary outcome was rate of expulsion within six weeks postpartum. The rate of expulsion was compared by method of insertion, either using a manual technique versus using ring forceps. Univariable analyses were performed for the association between baseline maternal characteristics and the primary outcome.

Results

A total of 219 participants met eligibility with 117 immediate ppIUDs inserted manually and 102 inserted with ring forceps. Baseline maternal demographics were similar across study groups. In unadjusted analysis, expulsion rate in patients who had IUDs placed using ring forceps was significantly higher as compared to manual insertion (30.4% vs 16.2%, p =0.01). After adjusting for factors determined a priori (estimated blood loss, body mass index, GA at delivery, multiparity, type of IUD), ring forceps continued to be significantly more likely to result in expulsion (adjusted OR (aOR) 2.45, CI 1.28-4.90).

Conclusions

Insertion of immediate ppIUD with ring forceps was associated with a significantly increased rate of expulsion within six weeks postpartum when compared with manual insertion.

查看原文本刊更多论文

插入方法与产后宫内节育器立即排出率的关系：回顾性队列研究

方法我们对 2014 年 1 月至 2023 年 9 月期间在拉什大学进行单胎阴道分娩并立即植入宫内节育器（ppIUD）的患者进行了回顾性队列研究。如果受试者出现产后出血、没有插入数据或没有产后随访记录，则将其排除在外。主要结果是产后六周内的排出率。排出率按插入方法进行比较，即使用手动技术还是使用环形镊子。对产妇基线特征与主要结果之间的关系进行了单变量分析。结果共有 219 名参与者符合条件，其中 117 人采用人工方式立即插入 ppIUD，102 人采用环形钳插入。各研究组产妇的基线人口统计学特征相似。在未经调整的分析中，使用环形钳放置宫内节育器的患者的宫内节育器排出率明显高于人工放置的患者（30.4% vs 16.2%，P =0.01）。在对事先确定的因素（估计失血量、体重指数、分娩时性别、多胎性、宫内节育器类型）进行调整后，环形钳仍明显更容易导致宫内节育器脱出（调整后 OR (aOR) 2.45，CI 1.28-4.90）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.