Post-Placental Intrauterine Device Insertion in Brazilian Adolescents: Clinical Outcomes at 12 Months.

STUDY

OBJECTIVE

To assess the acceptability, expulsion and continuation rates, satisfaction, and complications associated with post-placental intrauterine device insertion (PPIUDI) in Brazilian adolescents

DESIGN

Prospective cohort

SETTING

A single public, tertiary teaching hospital

PARTICIPANTS

Adolescents (≤ 19 years) giving birth by vaginal delivery or cesarean section INTERVENTION: PPIUDI MAIN OUTCOME MEASURES: Primary outcomes were PPIUDI acceptability, expulsion, continuation, and user satisfaction. Secondary outcomes were changes in menstrual bleeding and pain, infection, uterine perforation, and repeat pregnancy up to 12 months after PPIUDI.

RESULTS

Of 1710 adolescents who delivered during the study period, 294 accepted PPIUDI (acceptability 17.2%). There were no cases of infection or uterine perforation among the 91 adolescents who completed the 12-month follow-up. Overall expulsion rate was 28.6%, and most cases (54%) occurred in the first 6 weeks after insertion. At 12 months, 85.7% of users were satisfied with the method, and continuation rate was 69.2%. At the end of 12 months, there were no repeat pregnancies among the adolescents who remained with the device in place.

CONCLUSION

PPIUDI can be an effective and safe method to reduce repeat unplanned pregnancies in adolescents who have just given birth.