Expulsion rates and risk factors for intrauterine device expulsion following medical management of first-trimester incomplete abortions: A prospective cohort study in central Uganda
Rattachement africain : Ouganda, se. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: Intrauterine device (IUD) user rates remain below 5% in low-income countries yet fertility after first-trimester abortions returns within 2 weeks. IUDs provide effective contraception. This study set out to explore the risk factors for IUD expulsion after medical management of first-trimester incomplete abortions. DESIGN: Prospective cohort study SETTING: Multicentre study at five public health facilities in central Uganda. PARTICIPANTS: 1050 women with first-trimester incomplete abortion managed with misoprostol, recruited on giving informed consent. INTERVENTION: After selecting either copper or levonorgestrel (LNG) IUDs, participants were randomised to early (within 1 week) or standard (at 2-4 weeks) insertion and assessed on IUD expulsion 6 months later. MAIN OUTCOME MEASURES: Primary outcome was IUD expulsion rates at 6 months. Secondary outcomes were risk factors for IUD expulsions. RESULTS: Between 8 July 2023 and 31 May 2024, 532 (50.7%) participants chose LNG IUDs, 488 (46.5%) chose copper IUDs, while 30 (2.9%) participants chose not to use IUDs. The IUD expulsion rate was 4.6% (95% CI 3.48 to 6.07). IUD expulsion was significantly associated with low overall satisfaction with IUD insertion procedure and use (adjusted odds ratio (aOR)=7.99, 95% CI 4.83 to 13.22, p<0.001), anxiety during the IUD insertion (aOR=4.28, 95% CI 1.09 to 16.85, p=0.038), use of ultrasound at follow-up (aOR=8.41, 95% CI 4.56 to 15.5, p<0.001) and breastfeeding at the time of IUD insertion (aOR=1.48, 95% CI 0.26 to 4.98, p=0.042). CONCLUSION: Offering IUD insertion immediately after medical management of first-trimester incomplete abortion is associated with low expulsion rates and should be offered as a safe choice.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Expulsion rates and risk factors for intrauterine device expulsion following medical management of first-trimester incomplete abortions: A prospective cohort study in central Uganda
- Date Crossref
- 12/01/2026
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Makerere University Department of Obstetrics and Gynaecology Makerere University, Ouganda (code pays fourni par la source)Université ou école supérieure
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Karolinska Institutet Department of Women's and Children’s Health pays non établi dans la noticeUniversité ou école supérieure
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Karolinska University Hospital WHO collaborating center for Human Reproduction pays non établi dans la noticeÉtablissement de santé
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School of Public Health Department of Epidemiology and Biostatistics Makerere, Ouganda (pays nommé en fin d’affiliation)Université ou école supérieure
Department of Obstetrics and Gynaecology — Makerere University (Makerere University, Ouganda), Department of Women's and Children’s Health — Karolinska Institutet et WHO collaborating center for Human Reproduction — Karolinska University Hospital, avec 1 autre affiliation. Pays d’affiliation : Ouganda.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.