Abstract
Postpartum insertion of intrauterine contraceptive devices (IUDs) performed while women are still in hospital has a number of advantages. Earlier reports, however, generally associated this procedure with high expulsion rates. Recent studies, on the other hand, have shown that if IUDs are inserted immediately (within 10 minutes) after placental delivery, it is safe and effective. In some experienced centers, fairly low expulsion rates are reported. In this paper the experiences with postplacental IUD insertions from international studies are reviewed, the lessons we have learned from these experiences summarized, and future research directions suggested.
Resumé
La mise en place d'un dispositif intra-utérin (DIU) après un accouchement, alors que les femmes se trouvent encore à l'hôpital, présente un certain nombre d'avantages. Toutefois, dans des rapports antérieurs, cette pratique a généralement été associée à des taux de rejet élevés. D'autre part, des études récentes ont montré que si l'insertion du DIU de fait immédiatement après l'expulsion du placenta (dans les 10 minutes qui suivent), cette méthode est sûre et efficace. Certains centres expérimentés ont rapporté des taux de rejet relativement faibles. La présente étude passe en revue les expériences décrites dans des études internationales sur les insertions des DIU après le post-partum, résume les enseignements tirés de ces expériences et suggère des orientations pour les recherches futures.
Resumen
La inserción de un dispositivo intrauterino (DIU) después des parto, mientras las mujeres continúan hospitalizadas, presenta cierto número de ventajas. Sin embargo, en informes anteriores, esta práctica estuvo asociada generalmente con tasas elevadas de rechazo. Por otra parte, estudios recientes señalaron que si la inserción del DIU se realiza immediatamente después de la expulsión de la placenta (dentro de los 10 minutos siguientes), este método es seguro y eficaz. Ciertos centros experimentados señalaron tasas de rechazo relativamente bajas. En este estudio se examinan las experiencias descritas en estudios internacionales sobre las inserciones posparto de DIU, se resumen las lecciones aprendidas de estas experiencias y se sugieren orientaciones para futuras investigaciones.
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Chi, IC., Farr, G. Postpartum IUD contraception — a review of an international experience. Adv Contracept 5, 127–146 (1989). https://doi.org/10.1007/BF01849356
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DOI: https://doi.org/10.1007/BF01849356