- Levonorgestrel (LNG) 52 mg intrauterine system (IUS) has lower expulsion rate after postplacental insertion.
Why this matters
- Traditionally, no contraception is initiated in the immediate postpartum period, an underused window of opportunity to access health care.
- Cumulative partial or complete expulsion rate at 90 days was 36.7% for TCu380A intrauterine device (IUD) and 20% for LNG IUS.
- Most expulsions occurred by 42-day visit:
- TCu380A IUD: 17/39 vaginal deliveries and 4/31 cesarean deliveries (CDs).
- LNG IUS: 8/35 vaginal deliveries and 4/35 CDs.
- Expulsion rates were higher in women with vaginal delivery compared with CD and in women with 1 or ≥3 deliveries compared with 2 deliveries.
- Open-label, parallel-group, randomized trial.
- Women in prodromal labor or scheduled for elective CD were invited to participate.
- Women were randomly assigned to receive TCu380A IUD (n=70) vs LNG IUS (n=70).
- Data were collected at 42 and 90 days after IUD/IUS placement.
- Expulsion rates were compared.
- Funding: Fundação de Apoio à Pesquisa do Estado de São Paulo and Brazilian National Research Council. The TCu380A IUDs were donated by Pregna, Mumbai, India, and LNG-IUSs by the International Contraceptive Access Foundation, Turku, Finland.
- Parity was unbalanced.
- Small numbers in study.