1. FIGO postpartum intrauterine device initiative: Complication rates across six countries.
- Author
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Makins, Anita, Taghinejadi, Neda, Sethi, Maya, Machiyama, Kazuyo, Munganyizi, Projestine, Odongo, Elly, Divakar, Hema, Fatima, Parveen, Thapa, Kusum, Perera, Gamini, and Arulkumaran, Sabaratnam
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INTRAUTERINE contraceptives , *POSTPARTUM contraception , *PREGNANCY complications , *ACQUISITION of data , *MEDICAL care , *CONTRACEPTION , *HEALTH planning , *HOSPITALS , *POSTNATAL care , *PUERPERIUM , *FAMILY planning - Abstract
Objective: To record and analyze complication rates following postpartum intrauterine device (PPIUD) insertion in 48 hospitals in six countries: Sri Lanka, India, Nepal, Bangladesh, Tanzania, and Kenya.Methods: Healthcare providers were trained in counselling and insertion of PPIUD via a training-the-trainer model. Data were collected on methodology, timing, cadre of staff providing care, and number of insertions. Data on complications were collected at 6-week follow-up. Statistical analysis was performed to elucidate factors associated with increased expulsion and absence of threads.Results: From May 2014 to September 2017, 36 766 PPIUDs were inserted: 53% vaginal and 47% at cesarean delivery; 74% were inserted by doctors. Follow-up was attended by 52%. Expulsion and removal rates were 2.5% and 3.6%, respectively. Threads were not visible in 29%. Expulsion was less likely after cesarean insertion (aOR 0.33; 95% CI, 0.26-0.41), following vaginal insertion at between 10 minutes and 48 hours (aOR 0.59; 95% CI, 0.42-0.83), and when insertion was performed by a nurse (aOR 0.33; 95% CI, 0.22-0.50).Conclusion: PPIUD has low complication rates and can be safely inserted by a variety of trained health staff. Given the immediate benefit of the one-stop approach, governments should urgently consider adopting this model. [ABSTRACT FROM AUTHOR]- Published
- 2018
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