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. 2024 Apr:132:110362.
doi: 10.1016/j.contraception.2024.110362. Epub 2024 Jan 7.

Longitudinal impact of a residency-based postplacental levonorgestrel intrauterine device insertion program: Expulsion rates in years 1, 2, and 3

Leanne L Free  1 , Benjamin P Brown  2 , Kristen A Matteson  3 , Beth Cronin  4 , Phinnara Has  5 , Victoria Zeyl  6 , Rebecca H Allen  7
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Free article

Longitudinal impact of a residency-based postplacental levonorgestrel intrauterine device insertion program: Expulsion rates in years 1, 2, and 3

Leanne L Free et al. Contraception. 2024 Apr.
Free article

Abstract

Objective: To evaluate expulsion rates in the first 3 years of an academic postplacental levonorgestrel intrauterine device (LNG-IUD) insertion program.

Study design: Retrospective case series, January 2016 to December 2018. We measured LNG-IUD expulsion rates by 12 weeks postpartum.

Results: Of 235 LNG-IUD insertions, in years 1, 2, and 3, expulsion rates were 11/39 (28%), 9/94 (10%), and 15/102 (15%) (p = 0.03). After vaginal delivery, manual insertion was associated with a higher expulsion rate than ring-forceps (10/28 [36%] vs 17/105 [16%], p = 0.04).

Conclusions: LNG-IUD expulsion rates decreased after program year 1, suggesting program maturity may be associated with a lower expulsion risk.

Keywords: IUD expulsion; Medical education; Postpartum contraception; Postplacental IUD.

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