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Impact of training level on postplacental levonorgestrel 52?mg intrauterine device expulsion.


ABSTRACT: OBJECTIVE:To determine the association between provider training level and postplacental intrauterine device (IUD) outcomes following insertion instruction by email only. STUDY DESIGN:We conducted a single-center chart review of demographics, insertion and clinical outcomes within 6 months of delivery for 116 patients who underwent postplacental levonorgestrel 52?mg IUD placement from October 1, 2016, to March 31, 2017. RESULTS:We confirmed IUD retention, removal or expulsion in 87 of 116 (75.0%) patients by 6 months after delivery. Complete expulsion or removal for malposition occurred in 20 (23.0%) patients and more frequently after vaginal than cesarean delivery (30.2% vs. 4.2%, OR 9.93 [95% CI 1.25-78.96]) and when a postgraduate year (PGY) 1 physician placed the IUD compared to a PGY 2-4 or attending physician (37.5% vs. 14.5%, OR 3.52 [95% CI 1.25-9.94]). CONCLUSION:Postplacental levonorgestrel 52?mg IUD expulsion rates are associated with provider training level as well as delivery route, though the individual association of each of these factors is difficult to ascertain given the high degree of collinearity between these two variables in our study.

SUBMITTER: Cole M 

PROVIDER: S-EPMC6351181 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Impact of training level on postplacental levonorgestrel 52 mg intrauterine device expulsion.

Cole Madeline M   Thomas Stephanie S   Mercer Brian M BM   Arora Kavita Shah KS  

Contraception 20181116 2


<h4>Objective</h4>To determine the association between provider training level and postplacental intrauterine device (IUD) outcomes following insertion instruction by email only.<h4>Study design</h4>We conducted a single-center chart review of demographics, insertion and clinical outcomes within 6 months of delivery for 116 patients who underwent postplacental levonorgestrel 52 mg IUD placement from October 1, 2016, to March 31, 2017.<h4>Results</h4>We confirmed IUD retention, removal or expulsi  ...[more]

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