Efficacy and tolerance of immediate post-abortion IUD
contraception
V. Liberis, N. Koutlaki, I. Tsikrikoni, T. Chartabas, P. Tsikouras,
G. Galazios
Department of Obstetrics & Gynaecology, Democritus University
of Thrace, Alexandroupolis, Greece
Objective: To assess the efficacy and
tolerance of IUD insertion for the initiation of contraception immediately after
induced abortion before the 10th week of gestation, according to different types
of anesthesia.
Methods: One hundred and ninety-eight parous women who referred
to the Department of Family Planning of our clinic due to an unwanted pregnancy
below 10th week in the years 1998–2002 were included in the study. After a
counseling session concerning initiation of contraception, all women gave their
consent to be subjected to IUD insertion immediately after abortion. General
intravenous anesthesia was performed on 107 of them while in the rest 91 IUDs
were placed under paracervical blockade. The type of anesthesia was selected
according to the medical history of the women, to the personal preference of
each one of them as well as to their willing to minimize the time for the
scheduled abortion. A clinical and ultrasound follow up was performed on all
women immediately after operation, 2 weeks, 6 weeks and 1 year after operation.
Immediate or late complications were evaluated such as unsuccessful operation,
IUD expulsion, postoperative pain, genital infections, abnormal bleeding,
improper placement of the IUD, as well as the contraceptive efficacy of the
method.
Results: In the group of women who were subjected to paracervical
blockade a statistically significant difference was observed concerning the
inability to have the operation completed (p50.05), as well as the lack of
immediate postoperative pain (p50.01). No significant differences were noticed
between the two groups concerning the rest of the parameters evaluated.
Conclusions: IUD insertion immediately after induced early abortion by use of
paracervical blockade is a safe and well – tolerated method, which both
facilitates family planning services by simplifying the medical part of the
procedure and releases the women from the need of a late start of contraception.
