Single-visit long-acting reversible contraception provision and pregnancy rates within 3 months.
copper IUD
hormonal IUD
implant
intrauterine devices
pregnancy
single visit placement
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:
Jun 2023
Jun 2023
Historique:
revised:
17
11
2022
received:
17
09
2022
accepted:
07
12
2022
medline:
17
5
2023
pubmed:
18
12
2022
entrez:
17
12
2022
Statut:
ppublish
Résumé
To assess the occurrence of pregnancy in a cohort of women who received a copper intrauterine device (IUD), hormonal IUDs or an etonogestrel (ENG) contraceptive implant at a single-visit practice. Prospective study conducted at the University of Campinas, Campinas, São Paulo, Brazil. We obtained data from four ongoing studies including both the date of the device placement, the first day of the last menstrual period, and the occurrence of pregnancy up to 3 months after device placement. We included 2479 device placements (413 TCu380A IUDs, 1476 hormonal IUD and 590 ENG implants). Almost half of the device placements (1113/2479; 44.9%) were performed within the first 5 days of the menstrual cycle. We observed three pregnancies: one in an ENG implant user who received the implant within days 1-5 of the menstrual cycle; one in a woman who received a hormonal IUD during days 6-10 of the menstrual cycle; and one in a copper IUD user with placement during days 21-25 of menstrual cycle. Single-visit long-acting reversible contraception placements are a good strategy with overall very low pregnancy rates. This strategy has a potential to reduce unintended pregnancies and to reduce costs and barriers to both women and the healthcare system.
Substances chimiques
Levonorgestrel
5W7SIA7YZW
Contraceptive Agents, Female
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1028-1032Subventions
Organisme : Conselho Nacional de Desenvolvimento Científico e Tecnológico
ID : 573747/2008-3
Organisme : FAPESP
ID : 2015/20504-9
Informations de copyright
© 2022 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(21):1998-2007.
Bearak J, Popinchalk A, Alkema L, Sedgh G. Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model. Lancet Glob Health. 2018;6:e380-e389.
Hubacher D, Cheng D. Intrauterine devices and reproductive health: American women in feast and famine. Contraception. 2004;69:437-446.
Goodman S, Hendlish SK, Benedict C, Reeves MF, Pera-Floyd M, Foster-Rosales A. Increasing intrauterine contraception use by reducing barriers to post-abortal and interval insertion. Contraception. 2008;78:136-142.
Leeman L. Medical barriers to effective contraception. Obstet Gynecol Clin North Am. 2007;34:19-29.
Harper CC, Blum M, de Bocanegra HT, et al. Challenges in translating evidence to practice: the provision of intrauterine contraception. Obstet Gynecol. 2008;111:1359-1369.
Division of Reproductive Health, Health Promotion, & Prevention, Division of Reproductive Health National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC). U.S. selected practice recommendations for contraceptive use, 2013: adapted from the World Health Organization selected practice recommendations for contraceptive use, 2nd edition. MMWR Recomm Rep. 2013;62:1-60.
Cremer M, Bullard KA, Mosley RM, et al. Immediate vs. delayed postabortal copper T 380A IUD insertion in cases over 12 weeks of gestation. Contraception. 2011;83:522-527.
Bednarek PH, Creinin MD, Reeves MF, et al. Immediate versus delayed IUD insertion after uterine aspiration. NEJM. 2011;364:2208-2217.
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice; Long-Acting Reversible Contraception Working Group. ACOG Committee opinion no. 450: increasing use of contraceptive implants and intrauterine devices to reduce unintended pregnancy. Obstet Gynecol. 2009;114:1434-1438.
World Health Organization. Selected Practice Recommendations for Contraceptive Use. 3rd ed.. World Health Organization; 2016 Available at https://www.who.int/publications/i/item/9789241565400. Accessed on December 15, 2021
Gavin L, Moskosky S, Carter M, et al. Providing quality family planning services: recommendations of CDC and US Office of population affairs. MMWR Recomm Rep. 2014;63:11.
Curtis KM, Jatlaoui TC, Tepper NK, et al. US selected practice recommendations for contraceptive use, 2016. MMWR Recomm Rep. 2016;65:1-66.
Tepper NK, Curtis KM, Jatlaoui TC, Whiteman MK. Removing barriers to contraception through use of criteria to assess pregnancy risk. Contraception. 2017;95:323-325.
Harville EW, Wilcox AJ, Baird DD, Weinberg CR. Vaginal bleeding in very early pregnancy. Hum Reprod. 2003;18:1944-1947.
Castaño PM, Westhoff CL. Experience with same-day placement of the 52 mg levonorgestrel-releasing intrauterine system. Am J Obstet Gynecol. 2020;222:S883.e1-S883.e6.
Richards M, Teal SB, Sheeder J. Risk of luteal phase pregnancy with any-cycle-day initiation of subdermal contraceptive implants. Contraception. 2017;95:364-370.
Wilkinson TA, Downs SM, Edmonds BT. Cost minimization analysis of same-day long-acting reversible contraception for adolescents. JAMA Netw Open. 2019;2:e1911063.
Bergin A, Tristan S, Terplan M, Gilliam ML, Whitaker AK. A missed opportunity for care: two-visit IUD insertion protocols inhibit placement. Contraception. 2012;86:694-697.
Higgins TM, Dougherty AK, Badger GJ, Heil SH. Comparing long-acting reversible contraception insertion rates in women with Medicaid vs private insurance in a clinic with a two-visit protocol. Contraception. 2018;97:76-78.
Wilkinson TA, Edmonds BT, Cheng ER. Outcomes of a two-visit protocol for long acting reversible contraception for adolescents and young adults. Contraception. 2022;105:33-36.
Wachino V. State Medicaid payment approaches to improve access to long-acting reversible contraception. 2016. Available at https://www.medicaid.gov/federal-policy-guidance/downloads/cib040816.pdf. Accessed July 8, 2022.
Kaiser Family Foundation Intrauterine devices (IUDs): access for women in the U.S. 2016. Available at: https://www.kff.org/womens-health-policy/fact-sheet/intrauterine-devices-iuds-access-for-women-in-the-u-s/. Accessed July 10, 2022.
Le HH, Connolly MP, Bahamondes L, Cecatti JG, Yu J, Hu HX. The burden of unintended pregnancies in Brazil: a social and public health system cost analysis. Int J Womens Health. 2014;6:663-670.