Comparison between Two Techniques Used in Immediate Postplacental Insertion of TCu 380A Intrauterine Device：36-Month follow-up

Three hundred and eighty four women in Shanghai who delivered vaginally and chose IUD for contraception received the copper T-380A IUD inserted vaginatty within 10min after delivery of the placenta(i.e.,immediate postplacentat insertion,IPPI).Among them,98.70% were primipara.The women were randomly divided into twogroups:IUD inserted by hand and IUD insreted by ring forceps.Using Life Table Method and X^2test,expulsion and other discontinuation rates were compared at 6,12,24,and 36 months post-insertion between these two different groups.No uterine perforation,infection or prolonged period of lochia occurred in the 384 cases.Expulsions were the main reason for discontinuation.From 6 months to 36 months,the gross cumulative rates of all discontinuation events(expulsion, pregnancy,removal for bleed-ing/pain,etc.)were not statistically significantly different(P＞0.05).The results suggest that these two different insertion techniques do not significantly affect discontinuation rate in vaginal IPPI using the TCu 380A, which appears to be suitable for postpartum insertion in Chinese women.Other relevant issues,such as breast-feeding and IUD position in uterine cavity,are also analyzed and discussed in this paper.

Comparison between Two Techniques Used in Immediate Postplacental Insertion of TCu 380A Intrauterine Device: 36 Month follow up

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.