The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
David K Turok - One of the best experts on this subject based on the ideXlab platform.
-
immediate postpartum levonorgestrel Intrauterine Device insertion and breast feeding outcomes a noninferiority randomized controlled trial
American Journal of Obstetrics and Gynecology, 2017Co-Authors: David K Turok, Jennifer L Eggebroten, Jessica N Sanders, Lawrence Leeman, Lauren Thaxton, Nicole Yonke, Holly Bullock, Rameet H Singh, Lori M Gawron, Eve EspeyAbstract:Background Immediate postpartum levonorgestrel Intrauterine Device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. Objective This study examined the effect of immediate vs delayed postpartum levonorgestrel Intrauterine Device insertion on breast-feeding outcomes. Study Design We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel Intrauterine Device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery Results We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate group (79%; 95% confidence interval, 70–86%) was noninferior to that of the delayed group (84%; 95% confidence interval, 76–91%). The 5% difference in breast-feeding continuation at 8 weeks between the groups fell within the noninferiority margin (95% confidence interval, –5.6 to 15%). Time to lactogenesis (mean ± SD) in the immediate group, 65.3 ± 25.7 hours, was noninferior to that of the delayed group, 63.6 ± 21.6 hours. The mean difference between groups was 1.7 hours (95% confidence interval, –4.8 to 8.2 hours), noninferior by log-rank test. A total of 24 Intrauterine Device expulsions occurred in the immediate group compared to 2 in the delayed group (19% vs 2%, P Conclusion Our results of noninferior breast-feeding outcomes between women with immediate and delayed postpartum levonorgestrel Intrauterine Device insertion suggest that immediate postpartum Intrauterine Device insertion is an acceptable option for women planning to breast-feed and use the levonorgestrel Intrauterine Device. Expulsion rates are higher with immediate postpartum levonorgestrel Intrauterine Device insertion compared to delayed insertion, but this disadvantage may be outweighed by the advantages of immediate initiation of contraception. Providers should offer immediate postpartum Intrauterine Device insertion to breast-feeding women planning to use the levonorgestrel Intrauterine Device.
-
immediate postpartum Intrauterine Device and implant program outcomes a prospective analysis
American Journal of Obstetrics and Gynecology, 2017Co-Authors: Jennifer L Eggebroten, Jessica N Sanders, David K TurokAbstract:Background In-hospital placement of Intrauterine Devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum Intrauterine Device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel Intrauterine Device may have a higher expulsion rate than the copper Intrauterine Device. Objective This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 Intrauterine Devices, levonorgestrel Intrauterine Devices, and contraceptive implants. Study Design We offered enrollment in this prospective observational trial to women presenting to the University of Utah labor and delivery unit from October 2013 through February 2016 who requested an Intrauterine Device or implant for postpartum contraception during prenatal care or hospitalization at the time of delivery. Following informed consent, participants completed questionnaires prior to hospital discharge and at 3 and 6 months postpartum. Data on expulsions at 6 months were validated by chart abstraction. Results During the study period, 639 patients requested a postpartum Intrauterine Device or implant and 350 patients enrolled in prospective follow-up prior to discharge from the hospital. Among enrollees, 325 (93%) received their preferred contraceptive Device prior to hospital discharge: 88 (27%) copper Intrauterine Device users, 123 (38%) levonorgestrel Intrauterine Device users, and 114 (35%) implant users. Participants predominantly were Hispanic (90%), were multiparous (87%), reported a household income Conclusion An immediate postpartum long-acting reversible contraception program effectively provides women who desire highly effective reversible contraceptive Devices with their method of choice prior to hospital discharge. Immediate postplacental levonorgestrel Intrauterine Device users have higher expulsion rates than copper Intrauterine Device users, but >8 of 10 women initiating an Intrauterine Device or implant continue use at 6 months postpartum.
-
operative management of Intrauterine Device complications a case series report
Contraception, 2010Co-Authors: David K Turok, Shawn E Gurtcheff, Keri Gibson, Erin Handley, Sara E Simonsen, Patricia Aikins MurphyAbstract:Abstract Background There is limited information about the number of Intrauterine Device (IUD) users requiring operative intervention for Device-related complications. This is an evaluation of cases requiring in-hospital operative intervention for IUD perforations, removals and pregnancy-related complications. Study Design Large retrospective case series of patients who received operative management of IUD complications. Results Charts of patients from 15 hospitals in two health care systems from 2000 to 2007 were reviewed and outcomes of 276 women are reported. There were 95 operative IUD removals for perforations (including 60 levonorgestrel-releasing Intrauterine systems), 157 operative procedures for inability to remove an IUD in the office, and 42 pregnancy-related complications that were managed in the operating room. Ectopic pregnancy was the most common diagnosis among pregnant women (23 of 42 pregnant women, 54.8%). Conclusion The majority of operative procedures were performed for Intrauterine IUDs, most of which were appropriately positioned IUDs with missing or short strings. In-office techniques for obtaining analgesia and dilation as well as appropriate Devices for removal of T-shaped IUDs should make this practice rare.
Kathryn M. Curtis - One of the best experts on this subject based on the ideXlab platform.
-
Effectiveness and safety of extending Intrauterine Device duration: a systematic review.
American Journal of Obstetrics and Gynecology, 2020Co-Authors: Angeline J. Ti, Katherine C. Whitehouse, Ruben A. Smith, Mary E. Gaffield, Kathryn M. CurtisAbstract:Abstract Objective To systematically review the literature to determine if extended use of Intrauterine Devices including the copper or levonorgestrel Intrauterine Device beyond approved durations is effective and safe for preventing pregnancy. Data sources We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Global Index Medicus from inception through June 2019. Study eligibility criteria We considered primary studies of women using the T380A Copper or currently available levonorgestrel Intrauterine Devices past their approved duration (extended use). The primary outcome was pregnancy. Safety outcomes included adverse events and side effects that led to discontinuation. Study appraisal and synthesis methods We abstracted study data into evidence tables and assessed study quality as related to the risk of bias, precision, and external validity. For each Intrauterine Device type, we calculated a pooled pregnancy rate during the first two years of extended use using the Poisson inverse variance method. Results Of 4,068 studies identified by our search, four good to poor quality studies of the 52 mg levonorgestrel Intrauterine Device (approved for five years) with a total of 2098 women starting extended use, and two good to fair quality studies of the T380A copper Intrauterine Device (approved for 10 years) with 245 women starting extended use met inclusion criteria. For the levonorgestrel Intrauterine Device, the pooled pregnancy rate was 0.02 per 100 person-years (95% confidence interval 0.00-0.45) in year six, 0.03 per 100 person-years (95% confidence interval 0.00-0.71) in year 7, and 0.02 per 100 person-years (95% confidence interval 0.00-0.29) in years six and seven combined. During this same time, annual rates of adverse events or discontinuation due to side effects ranged from 0-3.7 per 100 participants. For the copper Intrauterine Device, the pooled pregnancy rate for years 11 and 12 was 0.0 per 100 person-years (95% confidence interval 0.0-0.8), and annual rates of adverse events and discontinuation due to side effects during extended use ranged from 0-4.6 per 100 participants. Conclusion The available evidence suggests that rates of pregnancy, adverse events, and discontinuation due to side effects during the first two years of extended use of the 52 mg levonorgestrel Intrauterine Device and the T380A copper Intrauterine Device are low and comparable to rates during approved duration of use. Data were limited in quantity and quality, and may not be generalizable to all Intrauterine Device users.
-
Intrauterine Device expulsion after postpartum placement a systematic review and meta analysis
Obstetrics & Gynecology, 2018Co-Authors: Tara C Jatlaoui, Maura K Whiteman, Gary Jeng, Naomi K Tepper, Erin Berrybibee, Denise J Jamieson, Polly A Marchbanks, Kathryn M. CurtisAbstract:OBJECTIVE:To estimate expulsion rates among women with postpartum Intrauterine Device (IUD) placement by timing of insertion, IUD type, and delivery method.DATA SOURCES:We searched PubMed, Cochrane Library, and ClinicalTrials.gov from 1974 to May 2018.METHODS OF STUDY SELECTION:We searched databases
-
postpartum Intrauterine Device insertion and postpartum tubal sterilization in the united states
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Maura K Whiteman, Kathryn M. Curtis, Naomi K Tepper, Denise J Jamieson, Ana Penmanaguilar, Polly A MarchbanksAbstract:Objective The purpose of this study was to estimate US rates of postpartum Intrauterine Device (IUD) insertion and postpartum tubal sterilization. Study Design Data from the 2001-2008 Nationwide Inpatient Sample were used to identify delivery hospitalizations with IUD insertion or tubal sterilization procedure codes. Results Estimated rates of postpartum IUD insertion and postpartum tubal sterilization were 0.27 and 770.67 per 10,000 deliveries, respectively. Although the rate of IUD insertion was similar across age groups, the rate of tubal sterilization increased with age. Nonetheless, 15% of tubal sterilizations occurred among women who were ≤24 years old. IUD insertion was more likely among women who delivered at teaching hospitals (odds ratio, 3.02; 95% confidence interval, 1.43–6.37); tubal sterilization was more likely among women without private insurance (odds ratio, 2.04; 95% confidence interval, 1.97–2.11). Conclusion Among US postpartum women, IUD insertion occurs considerably less frequently than tubal sterilization, even among younger women for whom poststerilization regret is a concern.
-
Intrauterine Device insertion during the postpartum period a systematic review
Contraception, 2009Co-Authors: Nathalie Kapp, Kathryn M. CurtisAbstract:Abstract Background Insertion of an Intrauterine Device (IUD) at different times or by different routes during the postpartum period may increase the risk of complications. Methods We searched Medline, Lilacs and Cochrane Collaboration databases for articles in any language, between database inception until December 2008, which compared outcomes of postpartum IUD insertion time intervals. Search terms included postpartum , puerperium , postcesarean delivery , cesarean section, IUD(s) , IUCD(s) , Intrauterine Device(s) and insertion . Results From 297 articles, we identified 15 for inclusion in this review: all studies examined the outcomes from copper IUD insertions within the postpartum time period compared to other time intervals or compared routes (vaginal or via hysterotomy) of postpartum insertion. No studies of levonorgestrel IUDs were identified. Immediate IUD insertion (within 10 min of placental delivery) was safe when compared with later postpartum time periods and interval insertion. Immediate postpartum IUD insertion demonstrated lower expulsion rates when compared with delayed postpartum insertion but with higher rates than interval insertion. Immediate insertion following cesarean delivery demonstrated lower expulsion rates than immediate insertion following vaginal delivery. Conclusion Poor to fair quality evidence from 15 articles demonstrated no increase in risk of complications among women who had an IUD inserted during the postpartum period; however, some increase in expulsion rates occurred with delayed postpartum insertion when compared to immediate insertion and with immediate insertion when compared to interval insertion. Postplacental placements during cesarean delivery are associated with lower expulsion rates than postplacental vaginal insertions, without increasing rates of postoperative complications.
Jennifer L Eggebroten - One of the best experts on this subject based on the ideXlab platform.
-
immediate postpartum levonorgestrel Intrauterine Device insertion and breast feeding outcomes a noninferiority randomized controlled trial
American Journal of Obstetrics and Gynecology, 2017Co-Authors: David K Turok, Jennifer L Eggebroten, Jessica N Sanders, Lawrence Leeman, Lauren Thaxton, Nicole Yonke, Holly Bullock, Rameet H Singh, Lori M Gawron, Eve EspeyAbstract:Background Immediate postpartum levonorgestrel Intrauterine Device insertion is increasing in frequency in the United States, but few studies have investigated the effect of early placement on breast-feeding outcomes. Objective This study examined the effect of immediate vs delayed postpartum levonorgestrel Intrauterine Device insertion on breast-feeding outcomes. Study Design We conducted this noninferiority randomized controlled trial at the University of Utah and the University of New Mexico Health Sciences Centers from February 2014 through March 2016. Eligible women were pregnant and planned to breast-feed, spoke English or Spanish, were aged 18-40 years, and desired a levonorgestrel Intrauterine Device. Enrolled women were randomized 1:1 to immediate postpartum insertion or delayed insertion at 4-12 weeks' postpartum. Prespecified exclusion criteria included delivery Results We met the enrollment target with 319 participants, but lost 34 prior to randomization and excluded an additional 26 for medical complications prior to delivery. The final analytic sample included 132 in the immediate group and 127 in the delayed group. Report of any breast-feeding at 8 weeks in the immediate group (79%; 95% confidence interval, 70–86%) was noninferior to that of the delayed group (84%; 95% confidence interval, 76–91%). The 5% difference in breast-feeding continuation at 8 weeks between the groups fell within the noninferiority margin (95% confidence interval, –5.6 to 15%). Time to lactogenesis (mean ± SD) in the immediate group, 65.3 ± 25.7 hours, was noninferior to that of the delayed group, 63.6 ± 21.6 hours. The mean difference between groups was 1.7 hours (95% confidence interval, –4.8 to 8.2 hours), noninferior by log-rank test. A total of 24 Intrauterine Device expulsions occurred in the immediate group compared to 2 in the delayed group (19% vs 2%, P Conclusion Our results of noninferior breast-feeding outcomes between women with immediate and delayed postpartum levonorgestrel Intrauterine Device insertion suggest that immediate postpartum Intrauterine Device insertion is an acceptable option for women planning to breast-feed and use the levonorgestrel Intrauterine Device. Expulsion rates are higher with immediate postpartum levonorgestrel Intrauterine Device insertion compared to delayed insertion, but this disadvantage may be outweighed by the advantages of immediate initiation of contraception. Providers should offer immediate postpartum Intrauterine Device insertion to breast-feeding women planning to use the levonorgestrel Intrauterine Device.
-
immediate postpartum Intrauterine Device and implant program outcomes a prospective analysis
American Journal of Obstetrics and Gynecology, 2017Co-Authors: Jennifer L Eggebroten, Jessica N Sanders, David K TurokAbstract:Background In-hospital placement of Intrauterine Devices and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum Intrauterine Device insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the levonorgestrel Intrauterine Device may have a higher expulsion rate than the copper Intrauterine Device. Objective This study evaluated in-hospital provision, expulsion, and 6-month continuation of immediate postpartum copper T380 Intrauterine Devices, levonorgestrel Intrauterine Devices, and contraceptive implants. Study Design We offered enrollment in this prospective observational trial to women presenting to the University of Utah labor and delivery unit from October 2013 through February 2016 who requested an Intrauterine Device or implant for postpartum contraception during prenatal care or hospitalization at the time of delivery. Following informed consent, participants completed questionnaires prior to hospital discharge and at 3 and 6 months postpartum. Data on expulsions at 6 months were validated by chart abstraction. Results During the study period, 639 patients requested a postpartum Intrauterine Device or implant and 350 patients enrolled in prospective follow-up prior to discharge from the hospital. Among enrollees, 325 (93%) received their preferred contraceptive Device prior to hospital discharge: 88 (27%) copper Intrauterine Device users, 123 (38%) levonorgestrel Intrauterine Device users, and 114 (35%) implant users. Participants predominantly were Hispanic (90%), were multiparous (87%), reported a household income Conclusion An immediate postpartum long-acting reversible contraception program effectively provides women who desire highly effective reversible contraceptive Devices with their method of choice prior to hospital discharge. Immediate postplacental levonorgestrel Intrauterine Device users have higher expulsion rates than copper Intrauterine Device users, but >8 of 10 women initiating an Intrauterine Device or implant continue use at 6 months postpartum.
Denise J Jamieson - One of the best experts on this subject based on the ideXlab platform.
-
Intrauterine Device expulsion after postpartum placement a systematic review and meta analysis
Obstetrics & Gynecology, 2018Co-Authors: Tara C Jatlaoui, Maura K Whiteman, Gary Jeng, Naomi K Tepper, Erin Berrybibee, Denise J Jamieson, Polly A Marchbanks, Kathryn M. CurtisAbstract:OBJECTIVE:To estimate expulsion rates among women with postpartum Intrauterine Device (IUD) placement by timing of insertion, IUD type, and delivery method.DATA SOURCES:We searched PubMed, Cochrane Library, and ClinicalTrials.gov from 1974 to May 2018.METHODS OF STUDY SELECTION:We searched databases
-
postplacental Intrauterine Device insertion at a teaching hospital
Contraception, 2014Co-Authors: Tara C Jatlaoui, Denise J Jamieson, Michele Marcus, Peggy Goedken, Carrie CwiakAbstract:Abstract Objective To determine whether postplacental Intrauterine Device (IUD) insertion can be safely and effectively performed within a teaching program. Study Design This was a prospective cohort of 177 subjects planning vaginal delivery enrolled antenatally who desired postplacental IUD insertion of either the copper T380A IUD or levonorgestrel IUS. Insertions were performed primarily by resident physicians following a training session. Follow-up included a 4- to 8-week visit and telephone calls at 3 and 6 months. Results Ninety-nine subjects underwent successful postplacental IUD insertion of 100 attempts. Seventeen expulsions (17%) were noted: 10 complete and 7 partial. The study identified no differences in outcome by training level; however, the study lacked statistical power to evaluate anything other than large differences. Conclusion Postplacental IUD insertions can be safely and effectively performed within a training program. Implications A training protocol may safely and feasibly be initiated among physicians, advanced practice clinicians or trainees with no prior experience with postplacental IUD insertion. By initiating this practice, access to highly effective contraception may increase for patients who have difficulty returning for a visit or otherwise receiving effective methods.
-
postpartum Intrauterine Device insertion and postpartum tubal sterilization in the united states
American Journal of Obstetrics and Gynecology, 2012Co-Authors: Maura K Whiteman, Kathryn M. Curtis, Naomi K Tepper, Denise J Jamieson, Ana Penmanaguilar, Polly A MarchbanksAbstract:Objective The purpose of this study was to estimate US rates of postpartum Intrauterine Device (IUD) insertion and postpartum tubal sterilization. Study Design Data from the 2001-2008 Nationwide Inpatient Sample were used to identify delivery hospitalizations with IUD insertion or tubal sterilization procedure codes. Results Estimated rates of postpartum IUD insertion and postpartum tubal sterilization were 0.27 and 770.67 per 10,000 deliveries, respectively. Although the rate of IUD insertion was similar across age groups, the rate of tubal sterilization increased with age. Nonetheless, 15% of tubal sterilizations occurred among women who were ≤24 years old. IUD insertion was more likely among women who delivered at teaching hospitals (odds ratio, 3.02; 95% confidence interval, 1.43–6.37); tubal sterilization was more likely among women without private insurance (odds ratio, 2.04; 95% confidence interval, 1.97–2.11). Conclusion Among US postpartum women, IUD insertion occurs considerably less frequently than tubal sterilization, even among younger women for whom poststerilization regret is a concern.
Tara C Jatlaoui - One of the best experts on this subject based on the ideXlab platform.
-
Intrauterine Device expulsion after postpartum placement a systematic review and meta analysis
Obstetrics & Gynecology, 2018Co-Authors: Tara C Jatlaoui, Maura K Whiteman, Gary Jeng, Naomi K Tepper, Erin Berrybibee, Denise J Jamieson, Polly A Marchbanks, Kathryn M. CurtisAbstract:OBJECTIVE:To estimate expulsion rates among women with postpartum Intrauterine Device (IUD) placement by timing of insertion, IUD type, and delivery method.DATA SOURCES:We searched PubMed, Cochrane Library, and ClinicalTrials.gov from 1974 to May 2018.METHODS OF STUDY SELECTION:We searched databases
-
postplacental Intrauterine Device insertion at a teaching hospital
Contraception, 2014Co-Authors: Tara C Jatlaoui, Denise J Jamieson, Michele Marcus, Peggy Goedken, Carrie CwiakAbstract:Abstract Objective To determine whether postplacental Intrauterine Device (IUD) insertion can be safely and effectively performed within a teaching program. Study Design This was a prospective cohort of 177 subjects planning vaginal delivery enrolled antenatally who desired postplacental IUD insertion of either the copper T380A IUD or levonorgestrel IUS. Insertions were performed primarily by resident physicians following a training session. Follow-up included a 4- to 8-week visit and telephone calls at 3 and 6 months. Results Ninety-nine subjects underwent successful postplacental IUD insertion of 100 attempts. Seventeen expulsions (17%) were noted: 10 complete and 7 partial. The study identified no differences in outcome by training level; however, the study lacked statistical power to evaluate anything other than large differences. Conclusion Postplacental IUD insertions can be safely and effectively performed within a training program. Implications A training protocol may safely and feasibly be initiated among physicians, advanced practice clinicians or trainees with no prior experience with postplacental IUD insertion. By initiating this practice, access to highly effective contraception may increase for patients who have difficulty returning for a visit or otherwise receiving effective methods.