Abstract

PIP: This 36-month follow-up study was conducted to compare the influence of the two insertion techniques used in immediate postplacental insertion (IPPI) in China. The study population comprised 384 women who delivered vaginally and chose to have the copper T-380A (TCu 380A) IUD inserted vaginally within 10 minutes after delivery. The women were randomly divided into groups. A total of 189 IUDs were inserted by hand; 195 were inserted by ring forceps. Expulsion and other discontinuation rates were compared at 6, 12, 24, and 36 months post-insertion between the two groups. Findings revealed that no uterine perforation, infection or prolonged period of lochia occurred among the 384 cases. There were 67 cases of expulsion, which was the main reason for the IPPI discontinuation. The gross cumulative expulsion rates for the manual insertion group after 6, 12, 24, and 36 months were 8.61, 13.55, 15.78, and 16.90 per 100 women, respectively. The gross cumulative expulsion rates for the ring forceps insertion group were 12.99, 17.23, 17.77, and 18.34 per 100 women, respectively. The differences between the two groups were not statistically significant. Findings suggest that the two different insertion techniques do not significantly affect discontinuation rates in vaginal IPPI using the TCu 380A IUD, which appears to be suitable for postpartum insertion in Chinese women. Other relevant issues, such as breast-feeding and IUD position in the uterine cavity, are also analyzed and discussed in this paper.