培训水平对产后左炔诺孕酮 52mg 宫内节育器脱落的影响。
Impact of training level on postplacental levonorgestrel 52 mg intrauterine device expulsion.
机构信息
Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109.
Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH 44109.
出版信息
Contraception. 2019 Feb;99(2):94-97. doi: 10.1016/j.contraception.2018.11.003. Epub 2018 Nov 16.
OBJECTIVE
To determine the association between provider training level and postplacental intrauterine device (IUD) outcomes following insertion instruction by email only.
STUDY DESIGN
We conducted a single-center chart review of demographics, insertion and clinical outcomes within 6 months of delivery for 116 patients who underwent postplacental levonorgestrel 52 mg IUD placement from October 1, 2016, to March 31, 2017.
RESULTS
We confirmed IUD retention, removal or expulsion in 87 of 116 (75.0%) patients by 6 months after delivery. Complete expulsion or removal for malposition occurred in 20 (23.0%) patients and more frequently after vaginal than cesarean delivery (30.2% vs. 4.2%, OR 9.93 [95% CI 1.25-78.96]) and when a postgraduate year (PGY) 1 physician placed the IUD compared to a PGY 2-4 or attending physician (37.5% vs. 14.5%, OR 3.52 [95% CI 1.25-9.94]).
CONCLUSION
Postplacental levonorgestrel 52 mg IUD expulsion rates are associated with provider training level as well as delivery route, though the individual association of each of these factors is difficult to ascertain given the high degree of collinearity between these two variables in our study.
目的
仅通过电子邮件提供插入说明来确定提供者培训水平与胎盘后宫内节育器（IUD）结果之间的关联。
研究设计
我们对 2016 年 10 月 1 日至 2017 年 3 月 31 日期间进行的 116 名接受左炔诺孕酮 52mg IUD 放置术的患者进行了单中心图表回顾，以确定分娩后 6 个月内的人口统计学，插入和临床结果。
结果
我们通过分娩后 6 个月确认了 116 例中有 87 例（75.0％）患者的 IUD 保留，取出或排出。由于位置不当，20 例（23.0％）患者完全排出或取出，阴道分娩的发生率高于剖宫产（30.2％比 4.2％，OR 9.93 [95％CI 1.25-78.96]），并且 PGY 1 医生放置 IUD 时，比 PGY 2-4 或主治医生更频繁（37.5％比 14.5％，OR 3.52 [95％CI 1.25-9.94]）。
结论
胎盘后左炔诺孕酮 52mg IUD 排出率与提供者的培训水平以及分娩方式有关，但鉴于这些两个变量在我们的研究中具有高度的共线性，因此很难确定每个因素的单独关联。
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