Post-Placental Intrauterine Device Insertion in Brazilian Adolescents: Clinical Outcomes at 12 Months

Assess the acceptability, expulsion and continuation rates, satisfaction, and complications associated with post-placental intrauterine device insertion (PPIUDI) in Brazilian adolescents DESIGN: : prospective cohort SETTING: : a single public, tertiary, teaching hospital PARTICIPANTS: : Adolescents (≤ 19 years) giving birth by vaginal delivery or cesarean section INTERVENTION: : Post-placental IUD insertion (PPIUDI) MAIN OUTCOME MEASURES: : Primary outcomes were PPIUDI acceptability, expulsion, continuation, and user satisfaction. Secondary outcomes were changes in menstrual bleeding and pain, infection, uterine perforation, and repeat pregnancy up to 12 months after PPIUDI RESULTS: : 294 of 1710 adolescents delivered during the study period accepted PPIUDI (acceptability 17.2%). There were no cases of infection or uterine perforation among the 91 adolescents who completed the 12 months follow-up. Overall expulsion rate was 28.6% and most cases (54%) occurred in the first six weeks after insertion. At 12 months, 85.7% of users were satisfied with the method and continuation rate was 69.2%. At the end of 12 months, there were no repeat pregnancies among the adolescents who remained with the device in place CONCLUSION: : PPIUDI can be an effective and safe method to reduce repeat unplanned pregnancies in adolescents who have just given birth.