Women Healthcare Department, CiXi Maternity and Child Health Care Hospital, Cixi, 315300, Zhejiang, China.
Gynecology Department, Hangzhou Women's Hospital, Hangzhou, 310000, Zhejiang, China.
Sci Rep. 2024 May 18;14(1):11385. doi: 10.1038/s41598-024-62327-1.
This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.
本文旨在报告即时放置宫内节育器（IUD）与人工流产后延迟放置的插入率、排出率、取出率和利用率的全面、最新分析和证据。综合检索了 PubMed、Embase、Cochrane、Web of Science、CNKI 和万方数据库，截至 2024 年 1 月 12 日，以比较人工流产后即时与延迟放置 IUD 的研究。评估指标包括手术或药物流产后放置 IUD 的数量、6 个月或 1 年内的排出和取出频率、继续使用的数量、疼痛强度评分、感染数量、出血持续时间以及放置 IUD 期间或之后子宫穿孔的情况。10 篇随机对照文章符合条件，包括 11 项研究项目，其中 3 项涉及手术流产后放置 IUD，8 项涉及药物流产后放置 IUD。共纳入 2025 名患者（即时放置组 977 名，延迟放置组 1048 名）。我们总结了所有提取的证据。荟萃分析结果表明，对于手术后流产，即时放置组的 IUD 放置率高于延迟放置组。药物流产后，即时放置组在 6 个月或 1 年内的 IUD 放置、利用和排出率更高。两组在取出率、放置后感染率、放置时疼痛评分和随访期间出血天数方面无统计学差异。与延迟放置相比，即时放置 IUD 不仅可以提高 6 个月或 1 年内的使用率，还可以提高放置率。
