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Master Thesis

Étude Cup & Fils : la longueur initiale des fils influe-t-elle sur l’expulsion des dispositifs intra-utérins chez les utilisatrices de la coupe menstruelle ? Étude épidémiologique prospective multicentrique débutée en 2020 en région Rhône Alpes et à Marseille auprès des femmes consultant en soins primaires

Abstract : Introduction: Concurrent intrauterine device and menstrual cup use may increase the risk of IUD expulsion. Further research is needed to determine mechanisms of expulsion. It may occur due to pinch the strings of IUD. In menstrual cup users, we investigate the association of strings length with IUD expulsion.Methods: Since February 2020, we conduct a prospective multicentred survey in Rhone Alpes and Marseille. We obtained approval from the Grenoble Alpes University and the CNIL to reach this study signing « MR-004 ». 32 medical offices had been asked to join the research. Eligible participants were women at least 18 years old, speaking French, and menstrual cup and IUD both users. Were exclude women who had a fast insertion less than 6 weeks after abortion. They were including by a practitioner or a midwife during IUD verification, 4 to 6 weeks after IUD insertion. The IUD strings could be cut shorts (≤ 1,5cm) or longs (≥ 2,0cm). The main outcome measure was complete or partial expulsion of the IUD within 12 months. We estimate that we would require at least 303 women to obtain sufficient numbers. The interim data was subjected to descriptive statistical analysis. The final data will be analysed according to a survival analysis with a Kaplan-Meier curve fitted with the Cox model. Results: 19 medical offices participated to this research. 18 practioners and midwifes had already included 44 women in 13 medical offices. Respectively, 48% and 52% women had the strings cut shorts or longs. Half of health professionals inserted directly the IUD. Cup and IUD users were young, in good health and nulliparous. They were likely to have copper IUDs. 14% had already at least one expulsion anteriority. 3 expulsions occurred between February and December 2020. 34% presented heavy menstrual bleeding and 23% dysmenorrhea.70% use menstrual cup and at least one other hygiene product. The removal process by pulling on the cup is used by 16% of women; 73% take care of removal the suction of the cervix before removal the cup. Discussion: We designed the first study about mechanisms expulsion of IUDs. The cup users were similar to others studies. Health professionals were more likely to cut the string’s IUDs shortly to cup users. In the future, withdrawals of this IUDs may be difficult. All risk factors of IUDs were asked to prevent some bias. The effective of expulsion IUD anteriority may influence the results. A lack of power is expected because of necessary sufficient number is not reached. Conclusion: The knowledge of the mechanisms of expulsion is essential to provide specific guidance necessary to an informed choice and offer preventive solutions to IUDs and cup users. An additional study is needed to investigate the relationship between expulsion IUD and cup. We may cumulate the effective of Cup & Fils and D-COUPE studies improving statistic power.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03134208
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Monday, February 8, 2021 - 11:36:51 AM
Last modification on : Thursday, February 11, 2021 - 3:17:12 AM
Long-term archiving on: : Sunday, May 9, 2021 - 6:26:14 PM

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  • HAL Id : dumas-03134208, version 1

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Caroline Pibault. Étude Cup & Fils : la longueur initiale des fils influe-t-elle sur l’expulsion des dispositifs intra-utérins chez les utilisatrices de la coupe menstruelle ? Étude épidémiologique prospective multicentrique débutée en 2020 en région Rhône Alpes et à Marseille auprès des femmes consultant en soins primaires. Médecine humaine et pathologie. 2021. ⟨dumas-03134208⟩

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