Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation

Miriam Cremer, Kimberley A. Bullard, Raegan Mc Donald Mosley, Christine Weiselberg, Michael Molaei, Veronica T. Lerner, Todd A. Alonzo

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: The intrauterine device (IUD) is a safe, effective, well-tolerated form of contraception. Immediate placement after second-trimester abortion could increase high-tier contraception use in women who are at high risk for unintended pregnancy. Study Design: This randomized controlled trial compared immediate vs. delayed placement of Copper T380A IUD insertion 2-4 weeks after second trimester abortion. The primary outcome analyzed was the percentage of women using a copper T380A IUD 6 months after surgery. Secondary outcomes were percentage of subjects using other high or middle tier contraception, expulsion, infection and repeat pregnancy rates as well as IUD satisfaction. In expectation of a high loss to follow-up at 6 months, 215 subjects were enrolled for a desired sample size of 158 subjects. Results: Contraceptive and pregnancy status at 6 months was known for 159 of 215 subjects. Women randomized to immediate insertion were significantly more likely to have an IUD at 6 months compared to delayed (81.7% vs. 28.4%, p=.003). Relative risk was 11.2 (95% CI 5-26). There were 8 (5.1%) of 159 repeat unintended pregnancies. No women had a repeat pregnancy that had an IUD placed in the operating room. In the as-treated analysis, 64 women in the immediate group received the IUD and 0% had a repeat pregnancy. Of the remaining 95 women, 8 (8.4%) had a repeat pregnancy. This is a statistically significant difference (p=.022). Conclusion: Placing the IUD immediately after the procedure significantly increases the likelihood of use of effective contraception following a second-trimester procedure. Women who have an IUD placed immediately after their procedure may also be less likely to have a subsequent unplanned pregnancy.

Original languageEnglish (US)
Pages (from-to)522-527
Number of pages6
JournalContraception
Volume83
Issue number6
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

Fingerprint

Intrauterine Devices
Copper
Pregnancy
Contraception
Second Pregnancy Trimester
Copper Intrauterine Devices
Unplanned Pregnancy
High-Risk Pregnancy
Pregnancy Rate
Operating Rooms
Contraceptive Agents
Sample Size
Randomized Controlled Trials
Infection

Keywords

  • Contraception
  • IUD insertion
  • Second trimester abortion
  • Unplanned pregnancy

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Cremer, M., Bullard, K. A., Mosley, R. M. D., Weiselberg, C., Molaei, M., Lerner, V. T., & Alonzo, T. A. (2011). Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation. Contraception, 83(6), 522-527. https://doi.org/10.1016/j.contraception.2010.10.005

Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation. / Cremer, Miriam; Bullard, Kimberley A.; Mosley, Raegan Mc Donald; Weiselberg, Christine; Molaei, Michael; Lerner, Veronica T.; Alonzo, Todd A.

In: Contraception, Vol. 83, No. 6, 01.06.2011, p. 522-527.

Research output: Contribution to journalArticle

Cremer, M, Bullard, KA, Mosley, RMD, Weiselberg, C, Molaei, M, Lerner, VT & Alonzo, TA 2011, 'Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation', Contraception, vol. 83, no. 6, pp. 522-527. https://doi.org/10.1016/j.contraception.2010.10.005
Cremer, Miriam ; Bullard, Kimberley A. ; Mosley, Raegan Mc Donald ; Weiselberg, Christine ; Molaei, Michael ; Lerner, Veronica T. ; Alonzo, Todd A. / Immediate vs. delayed post-abortal copper T 380A IUD insertion in cases over 12 weeks of gestation. In: Contraception. 2011 ; Vol. 83, No. 6. pp. 522-527.
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AU - Molaei, Michael

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AU - Alonzo, Todd A.

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