Immediate postplacental insertion of GYNE-T 380 and GYNE-T 380 Postpartum intrauterine contraceptive devices: Randomized study

In clinics in Belgium Chile and the Philippines data on 300 healthy sexually active acceptors of the GYNE- T 380 IUD were compared with data on 292 healthy sexually active acceptors of the GYNE-T 380 Postpartum IUD in order to compare the 10-year expulsion and efficacy rates of these 2 IUDs when inserted within 10 minutes of delivery of the placenta in a term pregnancy. The IUDs were identical except that the GYNE-T 380 Postpartum IUD was inserted by a temporary fundal suspension system while the GYNE-T 380 IUD was inserted directly into the uterus. No perforations occurred. The minimal complications that did occur were the same as those associated with interval IUD insertion: irregular spotting menorrhagia and uterine cramping. The rates for IUD discontinuation due to bleeding or pain and for other medical reasons were the same for both copper- releasing IUDs (3%). The removal rate for other medical reasons was less than 1% for each IUD. The only intrauterine pregnancy occurred in a woman using the nonsuspended standard GYNE-T 380 IUD. The IUD continuation rate was greater than 80% for each IUD. Within each clinic no statistically significant difference in the IUD expulsion rate existed at any time during the 12-month study period. Overall the expulsion rates for the 2 IUDs were similar (e.g. at 12 months 16.2% for GYNE-T 380 Postpartum IUD and 13.2% for GYNE-T 380 IUD). The Philippine clinic had significantly higher 1-year IUD expulsion rates regardless of IUD type than the Chilean clinic (24-32% vs. 5-6%). The Belgian clinic had moderately high 1-year IUD expulsion rates regardless of IUD type (8-16%). The different expulsion rates between clinics suggest differences in techniques used during insertion. These findings show that both IUD types inserted immediately after placental delivery are safe and acceptable. If the techniques associated with the low expulsion rates in Chile can be taught these IUDs can be a practical safe convenient and acceptable contraceptive method.