Celen Sevki, Möröy Perran, Sucak Ayhan, Aktulay Ayla, Danişman Nuri
Zekai Tahir Burak Women Health Education and Research Hospital, Ankara, Turkey.
Contraception. 2004 Apr;69(4):279-82. doi: 10.1016/j.contraception.2003.12.004.
To assess the efficacy, safety and, thus, advantages and disadvantages, of early postplacental intrauterine device (IUD) insertion.
IUDs were inserted within 10 min after postplacental expulsion in term pregnancy both in vaginal and cesarean deliveries via a ring forceps. Of the 276 patients enrolled, 235 were included in the study. Recipients were scheduled for examination before hospital discharge and at 6 weeks, 6 months and 12 months after postplacental insertion.
The percentages of women returning for a follow-up visit were 221 (94%), 210 (89%) and 183 (78%) at 6 weeks, 6 months and 12 months, respectively. Among IUD acceptors, 74% of the cases had vaginal deliveries and 26% had cesarean deliveries. Continuation rates were relatively high, 87.6% and 76.3%, at 6 and 12 months, respectively, after postplacental insertion of IUD. In this study, the 1-year cumulative expulsion rate with TCu 380A device was 12.3%, which may be regarded as a standard expulsion rate for immediate postplacental insertion of similar models of IUDs.
The evidence from this study suggests that immediate postplacental insertion of CuT 380 models is an effective, useful, safe, convenient and low-cost procedure for early postpartum contraception.
评估胎盘娩出后立即放置宫内节育器（IUD）的有效性、安全性及利弊。
足月妊娠经阴道分娩和剖宫产胎盘娩出后10分钟内，用环形钳放置IUD。纳入的276例患者中，235例纳入研究。受试者在出院前以及胎盘娩出后放置IUD的6周、6个月和12个月时进行检查。
6周、6个月和12个月时返回进行随访的女性百分比分别为221例（94%）、210例（89%）和183例（78%）。在接受IUD的患者中，74%为阴道分娩，26%为剖宫产。胎盘娩出后放置IUD，6个月和12个月时的续用率相对较高，分别为87.6%和76.3%。本研究中，使用TCu 380A装置的1年累积脱落率为12.3%，这可被视为类似型号IUD胎盘娩出后立即放置的标准脱落率。
本研究证据表明，胎盘娩出后立即放置CuT 380型号IUD是产后早期避孕的一种有效、实用、安全、方便且低成本的方法。
