Objective: To determine the frequency of expulsion of the intrauterine device TCu380A (IUD) inserted either immediately postpartum or after a delayed period. We aimed to identify the factors associated with expulsion.
Materials and methods: A longitudinal and comparative study was carried out in three Family Medicine Units of the Instituto Mexicano del Seguro Social (IMSS) of Leon, Guanajuato. One hundred twenty-five women who had a vaginal delivery and who elected to have IUD inserted immediately after delivery participated in the study along with 125 women who elected to have the IUD inserted after a delayed period after delivery. Studied factors were parity, technique, and insertion by the doctors assigned to the service and medical personnel in training (pre or postdegree). A medical review was performed one month and three months after insertion of the IUD. Results were analyzed by chi-square and Student t test.
Results: The expulsion rates of IUDs during immediate puerperium and also after a delayed period were 16 and 2.7%, respectively (p<0.0004). There was no statistically significant association between expulsion of the IUD and the following factors that were taken into account: age, primipara, personnel who inserted the device, and the application technique. In immediate puerperium, 25.9% of women who had multiple deliveries expelled the IUD, and in those who delayed IUD insertion, it was 4% (p=0.03).
Conclusions: There is a greater risk of expulsion if the IUD is inserted immediately after delivery and it is associated with multiparity. The percentage of expulsion in immediate puerperium is similar to that reported in the literature.