A randomized trial of levonorgestrel intrauterine system insertion 6 to 48 h compared to 6 weeks after vaginal delivery; lessons learned

作者：Stuart Gretchen S^*; Lesko Catherine R; Stuebe Alison M; Bryant Amy G; Levi Erika E; Danvers Antoinette I

来源：Contraception, 2015, 91(4): 284-288.

DOI：10.1016/j.contraception.2014.12.009

• Postpartum
• Contraception
• Intrauterine device
• Levonorgestrel
• Family planning

The objective of this randomized trial was to compare breastfeeding among women who received a levonorgestrel-releasing intrauterine system within 6-48 h (early) or 4-6 weeks (standard) after an uncomplicated vaginal birth. Analysis groups of 86 women in each arm were needed to demonstrate a 20% difference in any breastfeeding. Thirty-five women were randomized to the early (N=17) and standard (N=18) arms. The combination of unsuccessful placement (2/17; 12%), expulsions (7/17; 41%) and removals (3/17; 18%) reached 71% (12/17) in the early arm, so the study was stopped. In our small study cohort, levonorgestrel-releasing intrauterine system insertion between 6 and 48 h after vaginal birth was associated with a high rate of expulsion or removal soon after insertion.

• 出版日期2015-4