Dataset Information

Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery.

ABSTRACT: Objective:The objective was to describe the sonographic position of copper intrauterine devices (IUDs) 6 months after insertion during cesarean delivery. Study design:This prospective, observational study followed participants who received a copper IUD during cesarean delivery. We performed pelvic examination at 6?weeks and 6?months and sonography at 6?months to determine IUD position. Patients had additional examinations as needed to address complications. Results:Sixty-nine participants provided outcomes through 6 months: 41 (59%) had correctly positioned IUDs, 21 (30%) had malpositioned intrauterine IUDs, 5 experienced expulsion (3 partial, 2 complete), and 2 had elective removal; 52 (75%) had missing strings. Missing strings at 6 weeks predicted an incorrect IUD position in 22 of 52 participants (positive predictive value 42%), and visible or palpable strings predicted a correct IUD position in 7 of 12 participants (negative predictive value 58%). Conclusion:Although 59% of copper IUDs placed during cesarean were correctly positioned at 6?months, nearly one third were malpositioned. Implications:Ultrasound may be indicated for patients receiving a copper IUD during cesarean delivery as checking IUD strings alone does not assure correct placement. Providers offering postpartum IUDs should ensure that appropriate processes for the evaluation and management of devices with missing strings or abnormal position are available to all patients regardless of insurance status.

SUBMITTER: Gurney EP

PROVIDER: S-EPMC7644571 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery.

Gurney Elizabeth P EP McAllister Arden A Lang Britt B Schreiber Courtney A CA Sonalkar Sarita S

Contraception: X 20201009

<h4>Objective</h4>The objective was to describe the sonographic position of copper intrauterine devices (IUDs) 6 months after insertion during cesarean delivery.<h4>Study design</h4>This prospective, observational study followed participants who received a copper IUD during cesarean delivery. We performed pelvic examination at 6 weeks and 6 months and sonography at 6 months to determine IUD position. Patients had additional examinations as needed to address complications.<h4>Results</h4>Sixty-ni ...[more]

PMID: 33196037

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Project description:The contraceptive effectiveness of intrauterine devices has been attributed in part to effects of a foreign body reaction on the endometrium. We performed this study to identify compare the effects on the endometrial transcriptome of intrauterine devices and combined oral contraceptives, to better understand their mechanisms of action. We collected endometrial and cervical biopsies from women using the levonorgestrel-intrauterine device, copper intrauterine device or levonorgestrel-containing combined oral contraceptives, and from women not using contraceptives (control group). Transcriptional profiling was performed with Affymetrix arrays, Principal Component Analysis and the bioconductor package limma. Pathway analysis was performed using EnrichR and Reactome 2016. In endometrial samples from copper intrauterine device users (n=13), there were no genes with statistically significant differential expression compared to controls (n=11), whereas in levonorgestrel-intrauterine device users (n=11), 2509 genes were significantly dysregulated and mapped onto several immune and inflammatory pathways. In combined oral contraceptive users (n=12), 133 genes were significantly dysregulated and mapped predominantly onto pathways involving regulation of metal ions. Both levonorgestrel-intrauterine device and combined oral contraceptive use were associated with significant downregulation of members of the metallothionein gene family. In cervical samples, none of the groups showed statistically significant differential gene expression compared to controls. In conclusion, hormonal and copper intrauterine devices differ significantly in their effects on the endometrial transcriptome, with endometrium from copper intrauterine device users being indistinguishable from luteal phase endometrium. These results suggest that the contraceptive mechanisms of intrauterine devices are unlikely to rely on a common pathway involving a foreign body reaction in the endometrium.

Dataset Information

Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery.

Publications

Ultrasound assessment of postplacental copper intrauterine device position 6 months after placement during cesarean delivery.

Similar Datasets

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