Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2025
Efficacy and Success of Immediate Postpartum IUD Insertion in a Northern Ontario Tertiary Care Centre.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Splinter Karen, O'Connor Catherine, Lavoie Danika
Аннотация
OBJECTIVES: Immediate postpartum intrauterine device (PPIUD) insertion, despite being endorsed by the Society of Obstetricians and Gynecologists of Canada, is not a widely available practice in northern Ontario. This region is marked by obstetrical challenges such as delayed postpartum contraception discussions, high rates of missed follow-ups, and the use of less effective methods. This study aimed to assess the efficacy, adherence, and success of immediate PPIUD insertion in the northern Ontario context.
METHODS: This exploratory proof of concept study was conducted at Health Sciences North, a tertiary care centre in northern Ontario. Immediate PPIUD was defined as insertion within 10 minutes following delivery of the placenta. Participants had 3 follow-up visits over 1 year. Outcomes looked at efficacy and success, continuation rates at 1 year, complications, and overall patient satisfaction with PPIUD insertion.
RESULTS: Of 27 participants, 18 (66.7%) proceeded with immediate PPIUD, with high satisfaction (8.33/10) and recommendation (92%). All were hormonal intrauterine devices, and 11.1% were inserted during a cesarean delivery. Despite complications including partial embedding (1/18), low-lying rotation (1/18), and abnormal bleeding (6/27), only 16.7% experienced premature removal. Patients who had initially consented to receive immediate PPIUD insertion (33.3%) reported changing their mind, forgetting the device, and physician recommendations.
CONCLUSIONS: Immediate PPIUD insertion is safe and efficacious in a northern Ontario tertiary care setting. Our results underscore safety with minimal complications. Distinctions from existing literature include low discontinuation rates and high satisfaction. This method offers a promising solution to enhance postpartum care and reduce unplanned pregnancies in underserved regions.
METHODS: This exploratory proof of concept study was conducted at Health Sciences North, a tertiary care centre in northern Ontario. Immediate PPIUD was defined as insertion within 10 minutes following delivery of the placenta. Participants had 3 follow-up visits over 1 year. Outcomes looked at efficacy and success, continuation rates at 1 year, complications, and overall patient satisfaction with PPIUD insertion.
RESULTS: Of 27 participants, 18 (66.7%) proceeded with immediate PPIUD, with high satisfaction (8.33/10) and recommendation (92%). All were hormonal intrauterine devices, and 11.1% were inserted during a cesarean delivery. Despite complications including partial embedding (1/18), low-lying rotation (1/18), and abnormal bleeding (6/27), only 16.7% experienced premature removal. Patients who had initially consented to receive immediate PPIUD insertion (33.3%) reported changing their mind, forgetting the device, and physician recommendations.
CONCLUSIONS: Immediate PPIUD insertion is safe and efficacious in a northern Ontario tertiary care setting. Our results underscore safety with minimal complications. Distinctions from existing literature include low discontinuation rates and high satisfaction. This method offers a promising solution to enhance postpartum care and reduce unplanned pregnancies in underserved regions.