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Master Thesis

Pose du dispositif intra-utérin en post-partum immédiat : revue de la littérature dans 13 pays

Abstract : Introduction In France, according to the Haute Autorité de Santé, it is possible to do an immediate post-partum insertion (IPP) of an intrauterine device (IUD). However, this practice is still rare. This method seems to be especially indicated during the post-partum period because this contraception is sure, long-acting and reversible. Objectives Identify the favourable or the adverse consequences of IPP insertion of IUD. Review the different IUD insertion methods. Methods Review of the literature, through Pubmed and Embase data bases, of articles describing precisely the protocol of insertion of IUD, and evaluating the expulsion, infection, perforation and continuation rates. Have been considered articles written in English and published between 2008 and 2018. Results 22 articles from 13 countries were selected. It is shown that the expulsion rate is higher when the IUD is inserted during IPP compared to insertion 6 weeks after the delivery. However, after a few months, the continuation rate is similar in most studies. Perforations and infections do not increase when the IUD is inserted during IPP. Conclusion Intrauterine contraception is an appropriate answer to patients’ needs of a safe contraception during postpartum. Increased expulsion rate may be compensated by suitable information and a follow-up to quickly detect these expulsions and provide a device replacement. It is now necessary to communicate with health professionals about this possibility, through training (initial or continuous) and recommandations.
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Chloé Charbonnet. Pose du dispositif intra-utérin en post-partum immédiat : revue de la littérature dans 13 pays. Gynécologie et obstétrique. 2020. ⟨dumas-03251496⟩

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