Evaluation of clinical performance when intrauterine devices are inserted by different categories of healthcare professional.
Adolescent
Adult
Brazil
Child
Contraceptive Agents, Female
/ administration & dosage
Delivery of Health Care
Female
Health Personnel
/ statistics & numerical data
Hemorrhage
/ epidemiology
Humans
Intrauterine Devices, Copper
/ statistics & numerical data
Intrauterine Devices, Medicated
/ statistics & numerical data
Levonorgestrel
/ administration & dosage
Pregnancy
Retrospective Studies
Young Adult
Clinical performance
Copper intrauterine device
Levonorgestrel intrauterine system
Medical residents
Nurses
Physicians
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
received:
23
04
2020
revised:
02
07
2020
accepted:
22
09
2020
pubmed:
28
9
2020
medline:
13
4
2021
entrez:
27
9
2020
Statut:
ppublish
Résumé
We evaluated clinical performance when the TCu380A intrauterine device (IUD) and the levonorgestrel (LNG) 52-mg intrauterine system (IUS) were inserted by different categories of healthcare professionals. A retrospective study was conducted at the University of Campinas, Brazil. The medical records were reviewed of all women in whom an IUD was inserted between January 1980 and December 2018, with data for at least 1 year, and for whom information on the healthcare provider who inserted the device was available. Overall, 19 132 (76.9%) IUD and 5733 (23.1%) LNG-IUS insertions were included, with residents/interns performing 13 853 (55.8%), nurses 7024 (28.2%), and physicians 3988 (16.0%). Removals for pregnancy and infection were significantly higher when physicians inserted the device, while removals for bleeding/pain and other medical reasons were more common when nurses performed the insertion. Expulsion and removals for personal reasons were similar for all three categories. Clinical outcomes were similar regardless of whether trained nurses, residents/interns, or physicians inserted the device, and were irrespective of users' age and parity. These results could stimulate other healthcare services, particularly in regions where there is a shortage of physicians, to invest in training nurses to perform insertions of IUDs.
Substances chimiques
Contraceptive Agents, Female
0
Levonorgestrel
5W7SIA7YZW
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
196-201Subventions
Organisme : Fundação de Apoio à Pesquisa do Estado de São Paulo
Organisme : Brazilian National Research Council
Informations de copyright
© 2020 International Federation of Gynecology and Obstetrics.
Références
Winner B, Peipert JF, Zhao Q, et al. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366:1998-2007.
Family Planning Worldwide 2019 Data Sheet. Population Reference Bureau. https://www.prb.org/2019-family-planning-data-sheethighlights-family-planning-method-use-around-the-world/. Accessed February 17, 2020.
National Survey of Family Growth: Current contraceptive status and method used in month of interview among women 15-44 years of age, Special Tabulation by NCHS. https://www.cdc.gov/nchs/nsfg/key_statistics/c.htm#currentuse. Accessed January 22, 2020.
Guttmacher Institute. Fact Sheet. Adding it Up: Investing in Contraception and Maternal and Newborn Health. 2017: Guttmacher Institute; 2017.
Ponce de Leon RG, Ewerling F, Serruya SJ, et al. Contraceptive use in Latin America and the Caribbean with a focus on long-acting reversible contraceptives: Prevalence and inequalities in 23 countries. Lancet Glob Health. 2019;7:e227-e235.
Brasil. Conselho Federal de Medicina. https://portal.cfm.org.br/images/PDF/2019_nota_tecnica_diu.pdf. Accessed December 18, 2019.
Akin A, Gray RH, Ramos R. Training auxiliary nurse-midwives to provide IUD services in Turkey and the Philippines. Stud Fam Plann. 1980;11:178-187.
Eren N, Ramos R, Gray RH. Physicians vs. auxiliary nurse-midwives as providers of IUD services: A study in Turkey and the Philippines. Stud Fam Plann. 1983;14:43-47.
Lassner KJ, Chen CH, Kropsch LA, Oberle MW, Lopes IM, Morris L. Comparative study of safety and efficacy of IUD insertions by physicians and nursing personnel in Brazil. Bull Pan Am Health Organ. 1995;29:206-215.
Yadav V, Balasubramaniam S, Das S, et al. Comparison of outcomes at 6 weeks following postpartum intrauterine contraceptive device insertions by doctors and nurses in India: A case-control study. Contraception. 2016;93:347-355.
Kemeny F, Digiusto E, Bateson D. Insertion of intrauterine contraceptive devices by registered nurses in Australia. Aust N Z J Obstet Gynaecol. 2016;56:92-96.
World Health Organization. Medical eligibility Criteria For Contraceptive Use. Reproductive health and research. Geneva: World Health Organization; 2015.
Bahamondes L, Faundes A, Sobreira-Lima B, Lui-Filho JF, Pecci P, Matera S. TCu 380A IUD: A reversible permanent contraceptive method in women over 35 years of age. Contraception. 2005;72:337-341.
Bahamondes L, Fernandes A, Bahamondes MV, Juliato CT, Ali M, Monteiro I. Pregnancy outcomes associated with extended use of the 52-mg 20 μg/day levonorgestrel-releasing intrauterine system beyond 60 months: A chart review of 776 women in Brazil. Contraception. 2018;97:205-209.
Lohr PA, Lyus R, Prager S. Use of intrauterine devices in nulliparous women. Contraception. 2017;95:529-537.
Bahamondes MV, Hidalgo MM, Bahamondes L, Monteiro I. Insertion and clinical performance of the levonorgestrel-releasing intrauterine system in nulligravidas. Contraception. 2011;84:e11-16.
Zhang J, Feldblum P, Chi I-C, et al. Risk factors for copper T IUD expulsion: An epidemiologic analysis. Contraception. 1992;46:427-433.
Madden T, McNicholas C, Zhao Q, et al. Association of age and parity with intrauterine device expulsion. Obstet Gynecol. 2014;124:718-726.
World Health Organization. Task sharing to improve access to Family Planning/Contraception [Summary Brief]. 2017. https://www.who.int/reproductivehealth/publications/task-sharing-access-fp-contraception/en/. Accessed February 4, 2020.
Thompson KMJ, Rocca CH, Stern L, et al. Training contraceptive providers to offer intrauterine devices and implants in contraceptive care: A cluster randomized trial. Am J Obstet Gynecol. 2018;218:597.e1-597.e7.
Brasil. Ministério da Saúde; Secretaria de Políticas de Saúde, Área Técnica de Saúde da Mulher. Assistência em Planejamento Familiar: manual técnico, 4thª edn. Brasília: 2002.
Mhlanga FG, Balkus JE, Singh D, et al. Feasibility and safety of IUD insertion by mid-level providers in Sub-Saharan Africa. Int Perspect Sex Reprod Health. 2019;45:61-69.
Adeyemi-Fowode OA, Bercaw-Pratt JL. Intrauterine devices: Effective contraception with noncontraceptive benefits for adolescents. J Pediatr Adolesc Gynecol. 2019;32(5S):S2-S6.
Viellas EF, Domingues RM, Dias MA, et al. Assistência pré-natal no Brasil. Cad Saude Publica. 2014;30(Suppl.1):S1-S15.