Immediate postpartum insertion of a copper-wired intrauterine contraceptive device, the MLCu250.

ABSTRACT

PIP: In a Belgium study, MLCu250 IUDs were inserted in 600 women immediately after delivery. The women were followed for a total of 9843 women months of use, and the results were analyzed using the life table method. Cumulative continuation rates/100 users were 87.2 at 6 months, 72.7 at 12 months, and 55.8 at 30 months. Expulsion rates/100 users were 3.7 at 6 months, 5.8 at 12 months, and 6.0 at 18, 24, and 30 months. Removal rates for bleeding and pain/100 users were 4.3 at 6 months, 7.1 at 12 months, 9.1 at 18 months, 10.7 at 24 months, and 11.8 at 30 months. Removal rates decreased as the age of the patient increased. Parity did not greatly influence removal rates. 6 pregnancies occurred during the study period, none of which were ectopic. No serious complications were reported but inversion of the devices in the uterine cavity could result in perforation. Efforts to diagnosis inversion should be made, and the device removed if inversion has occurred. The regular MLCu250 inserter was found to be satisfactory while attempts to use a longer inserter proved cumbersome. Tables provide gross cumulative event rates/100 users at 6, 12, 18, 24, and 30 month intervals and at 12 and 24 month intervals by age and by parity. An additional table describes each of the unplanned pregnancies in terms of age, parity, previous IUD use, IUD position, IUD removal time, and interval between insertion and last menstrual cycle.