基于住院医师的胎盘后左炔诺孕酮宫内节育器插入项目的纵向影响：第 1、2 和 3 年的脱落率。
Longitudinal impact of a residency-based postplacental levonorgestrel intrauterine device insertion program: Expulsion rates in years 1, 2, and 3.
机构信息
Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Providence, RI, United States.
Lifespan Biostatistics, Epidemiology and Research Design Core, Rhode Island Hospital, Providence, RI, United States.
出版信息
Contraception. 2024 Apr;132:110362. doi: 10.1016/j.contraception.2024.110362. Epub 2024 Jan 7.
OBJECTIVE
To evaluate expulsion rates in the first 3 years of an academic postplacental levonorgestrel intrauterine device (LNG-IUD) insertion program.
STUDY DESIGN
Retrospective case series, January 2016 to December 2018. We measured LNG-IUD expulsion rates by 12 weeks postpartum.
RESULTS
Of 235 LNG-IUD insertions, in years 1, 2, and 3, expulsion rates were 11/39 (28%), 9/94 (10%), and 15/102 (15%) (p = 0.03). After vaginal delivery, manual insertion was associated with a higher expulsion rate than ring-forceps (10/28 [36%] vs 17/105 [16%], p = 0.04).
CONCLUSIONS
LNG-IUD expulsion rates decreased after program year 1, suggesting program maturity may be associated with a lower expulsion risk.
目的
评估学术背景下胎盘后置入左炔诺孕酮宫内节育器（LNG-IUD）项目实施头 3 年的脱落率。
研究设计
回顾性病例系列研究，2016 年 1 月至 2018 年 12 月。我们通过产后 12 周来测量 LNG-IUD 的脱落率。
结果
235 例 LNG-IUD 放置中，第 1、2、3 年的脱落率分别为 11/39（28%）、9/94（10%）和 15/102（15%）（p=0.03）。经阴道分娩后，手动放置与环钳放置相比，脱落率更高（10/28[36%] vs 17/105[16%]，p=0.04）。
结论
项目实施 1 年后 LNG-IUD 脱落率下降，提示项目成熟度可能与较低的脱落风险相关。
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