Evidence map›Paper›PMID 38945350›Full record

ArticleContraception2024

The association of insertion methods on immediate postpartum intrauterine device expulsion rates: A retrospective cohort study.

Elena Perkins, Jerome Federspiel, Deeya Bhattacharya, Samantha de Los Reyes

Abstract read
In one paragraph

Article in Contraception, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Manual versus forceps postplacental IUD insertion after vaginal delivery: A randomized clinical trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Elena PerkinsRush University Medical Center, Department of Obstetrics and Gynecology, Chicago, IL, United States. Electronic address: elena_m_perkins@rush.edu.
Jerome FederspielDuke University School of Medicine, Department of Obstetrics and Gynecology, Department of Population Health Sciences, Department of Medicine, Durham, NC, United States.
Deeya BhattacharyaRush Medical College, Chicago, IL, United States.
Samantha de Los ReyesRush University Medical Center, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Chicago, IL, United States.

Funding

Duke Women's Reproductive Health Research ScholarsK12HD103083 · NICHD · DUKE UNIVERSITY · PI Cindy Amundsen · 2020 to 2026
$2.2M
NICHD NIH HHS K12 HD103083
6 · The paper itself

Abstract

objectiveTo evaluate the method of immediate postpartum IUD (ppIUD) insertion (manual versus ring forceps) and expulsion rate within 6-week postpartum. STUDY

designWe performed a retrospective cohort study of patients who had a singleton vaginal delivery and an immediate ppIUD inserted at Rush University from January 2014 to September 2023. The primary outcome was rate of expulsion within 6-week postpartum. We compared the rate of expulsion by method of insertion, either using a manual technique versus using ring forceps. We performed univariable analysis for the association between baseline maternal characteristics and the primary outcome and we performed multivariable logistic regression to determine the independent association of the method of insertion and the primary outcome.

resultsTwo hundred nineteen patients met eligibility with 117 immediate ppIUDs inserted manually and 102 inserted with ring forceps. Baseline maternal demographics were similar across study groups. After adjusting for factors selected a priori (estimated blood loss, body mass index, gestational age at delivery, nulliparity, type of IUD), use of ring forceps was more likely to result in expulsion compared to manual insertion (30.4% vs 16.2% respectively; adjusted OR 2.49, 95% confidence interval 1.28-4.90).

conclusionIn this retrospective analysis, insertion of immediate ppIUD with ring forceps was independently associated with an increased rate of expulsion within 6 weeks postpartum when compared to manual insertion. IMPLICATIONS: In this setting, ring forceps was associated with high rates of immediate postpartum IUD expulsion compared to manual technique. Studies disagree, suggesting need for additional work.

Indexed as

Intrauterine Device ExpulsionIntrauterine DevicesPostpartum PeriodAdultFemaleHumansLogistic ModelsPregnancyRetrospective StudiesYoung AdultIUD expulsionIUD insertionLARCPostplacental IUD

Identifiers

PMID38945350
PMCPMC11464192

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.