Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis.

American Journal of Obstetrics and Gynecology
Sarah H AverbachTara C Jatlaoui

Abstract

To provide updated and more detailed pooled intrauterine device expulsion rates and expulsion risk estimates among women with postpartum intrauterine device placement by timing of insertion, delivery type, and intrauterine device type to inform current intrauterine device insertion practices in the United States. We searched PubMed, Cochrane Library, and ClinicalTrials.gov through June 2019. We included all studies, of any study design, that examined postpartum placement of Copper T380A (copper) or levonorgestrel-containing intrauterine devices that reported counts of expulsion. We evaluated intrauterine device expulsion among women receiving postpartum intrauterine devices in the "immediate" (within 10 minutes), "early inpatient" (>10 minutes to <72 hours), "early outpatient" (72 hours to <4 weeks), and interval (≥4 weeks) time periods after delivery. We assessed study quality using the US Preventive Services Task Force evidence grading system. We calculated pooled absolute rates of partial and complete intrauterine device expulsion separately and estimated adjusted relative risks by the timing of postpartum placement, delivery type, and intrauterine device type using log-binomial multivariable regression. We identified 48 lev...Continue Reading

Citations

May 26, 2020·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Anita MakinsUNKNOWN FIGO Contraception, Family Planning Committee
Jan 10, 2021·Acta Obstetricia Et Gynecologica Scandinavica·Marcos MarangoniCássia R T Juliato
Apr 3, 2021·Global Health, Science and Practice·Gillian EvaKim Dalziel
Jul 2, 2021·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Aureliana Barboza da Silva NóbregaCarolina Sales Vieira
Aug 31, 2021·American Journal of Obstetrics and Gynecology·Mariana Ramos-RiveraLynn L Ngo

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