A prospective cohort study of pain with intrauterine device insertion among women with and without vaginal deliveries

2014 ◽  
Vol 34 (3) ◽  
pp. 263-267 ◽  
Author(s):  
R. H. Allen ◽  
M. S. Carey ◽  
C. Raker ◽  
V. Goyal ◽  
K. Matteson
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intrauterine Device ◽  
Vaginal Deliveries

Intrauterine Device Use, Sexually Transmitted Infections, and Fertility: A Prospective Cohort Study

2021 ◽  
Vol 76 (12) ◽  
pp. 746-747
Author(s):  
Jeffrey F. Peipert ◽  
Qiuhong Zhao ◽  
Courtney A. Schreiber ◽  
Stephanie Teal ◽  
David K. Turok ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sexually Transmitted Infections ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intrauterine Device ◽  
Sexually Transmitted ◽  
Device Use

Evaluating Fundal Dominant Contractions on Spatiotemporal Electrohysterography as a Marker for Effective Labor Contractions

2018 ◽  
Vol 36 (09) ◽  
pp. 924-929 ◽  
Author(s):  
Rodney K. Edwards ◽  
Neil R. Euliano ◽  
Savyasachi Singh ◽  
Rachel C. LeDuke ◽  
William W. Andrews ◽  
...  
Keyword(s):  
Cohort Study ◽  
Vaginal Delivery ◽  
Prospective Cohort Study ◽  
Study Design ◽  
Prospective Cohort ◽  
Cervical Dilation ◽  
Labor Dystocia ◽  
Nulliparous Women ◽  
Vaginal Deliveries

Objective To evaluate if fundal (F) dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for labor dystocia. Study Design We conducted a prospective cohort study of nulliparous women in spontaneous labor at ≥36 weeks. Clinicians were blinded to electrohysterography data which were in addition to standard cardiotocography. All contractions in the hour preceding diagnosis of complete cervical dilation (for women delivering vaginally) or the hour preceding the decision for cesarean were analyzed. Results Of 224 patients, 167 had evaluable data. The proportion of F dominant contractions was not different for women undergoing cesarean for labor dystocia (n = 11) compared with all others (n = 156)—88.7 ± 10.2 versus 86.0 ± 11.4%; p = 0.44. Results were similar when comparing the cesarean for labor dystocia group to those undergoing cesarean for other indications (n = 10) and vaginal deliveries (n = 146)—88.7 ± 10.2 versus 86.5 ± 10.0 versus 85.9 ± 11.5%; p = 0.74. Conclusion We were unable to confirm our earlier finding that F dominance of the electrohysterogram is associated with vaginal delivery and lack of F dominance is associated with cesarean for dystocia.

Long-Acting Reversible Contraception Versus Pills/Patch/Ring

2021 ◽  
pp. 154-158
Author(s):  
Antoinette Danvers ◽  
Elizabeth B. Schmidt
Keyword(s):  
Cohort Study ◽  
Unintended Pregnancy ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intrauterine Device ◽  
Age Groups ◽  
Contraceptive Failure ◽  
Contraceptive Pill ◽  
Contraceptive Implant ◽  
Long Acting

The CHOICE study was a prospective cohort study of 7486 women in St. Louis, Missouri. The participants underwent standard, scripted contraceptive counseling and were provided with their choice of contraception at no cost. Primary outcomes were contraceptive failure and pregnancy rates in 2 age groups: women over 21 and less than 21 years old. Participants who chose long-acting reversible contraception (LARC) such as an intrauterine device or the contraceptive implant were less likely to experience a contraceptive failure compared to contraceptive pill, patch, ring (PPR) users (p = 0.001). Participants using PPR were 22 times more likely to have an unintended pregnancy than those using LARC. Among women less than 21 years old who used non-LARC methods, the risk of pregnancy was nearly twice as high than older women. LARC are highly-effective and safe for women of all ages and should be considered first-line methods of contraception for most patients.

scholarly journals Pelvic pain and early IUD discontinuation: a prospective cohort study

2019 ◽  
Vol 8 (3) ◽  
pp. 792
Author(s):  
Sharon R. Gerber ◽  
Noah Natell ◽  
Nora Doty ◽  
Xiaoyu Liu ◽  
Jessica R. Overbey ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Pelvic Pain ◽  
Prospective Cohort ◽  
Intrauterine Device ◽  
Significant Difference ◽  
History Of ◽  
One Year

Background: The aim of the study is to assess if pelvic pain is a risk factor for intrauterine device (IUD) discontinuation within one year of placement.Methods: This is a prospective cohort study of women who had IUDs inserted at a family planning office for the primary intent of contraception. Baseline pelvic pain characteristics were assessed using a validated pelvic pain questionnaire.  Women were contacted at 1 year to assess IUD continuation.Results: From February 1, 2014 to August 11, 2015 authors enrolled a sample of 179 women.  Of the 179 enrolled,163 participants completed the questionnaire, 98 reported a history of baseline pelvic pain and 65 reported no history of baseline pelvic pain. 20 participants were lost to follow-up. 86 women in the pelvic pain and 57 in the no pelvic pain group were included in the final analysis. Discontinuation rates at one year follow up were 25.6% (22) and 35.1% (20) respectively. There was no significant difference in those with and without pelvic pain discontinuing IUDs at one year (p = 0.22).Conclusions: Baseline generalized pelvic pain may not be a risk factor for IUD discontinuation within one year of placement.

scholarly journals Risk factors for postpartum intrauterine device expulsion among women delivering at a tertiary Hospital in Uganda: a prospective cohort study

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Joy Muhumuza ◽  
Richard Migisha ◽  
Joseph Ngonzi ◽  
Musa Kayondo ◽  
Godfrey Mugyenyi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Intrauterine Device ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
Limiting Factor ◽  
Expulsion Rate ◽  
Postpartum Family Planning

Abstract Background Postpartum intrauterine device (PPIUD) use refers to intrauterine device (IUD) insertion after delivery but within 48 h of birth. In Uganda, the general use of modern methods of contraception is low with < 1% of the women adopting the IUD as a method of contraception. An important limiting factor to increased uptake of immediate postpartum IUD insertion may be its expulsion rates which vary widely. There is minimal documentation PPIUD expulsion rates and factors associated with PPIUD expulsion during puerperium in Uganda. Objective We aimed to determine the proportion of TCu380A (copper) intrauterine devices expelled by 6 weeks postpartum, and identify risk factors for expulsion among women delivering at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Methods We conducted a prospective cohort study from September 1, 2014 to January 31, 2015 at MRRH. We administered a structured questionnaire to all participants, to capture data on their baseline demographic, clinical and obstetric characteristics. We followed up women who accepted the PPIUD insertions at 6 weeks post insertion for any IUD expulsion. We fit multivariable log binomial regression models to identify risk factors for IUD expulsion. Results We enrolled 167 women who had PPIUDs inserted. Of the144 women who returned at 6 weeks for follow up, 13 (9%; 95%CI:4.9–15%) of them had the IUDs expelled. In the multivariable model, the significant risk factors for PPIUD expulsion were: IUD insertion more than 10 min post-delivery (aRR 8.1, 95%CI 1.26–51.98, p = 0.027) and bloody lochia flow of ≥15 days (aRR 8.5, 95%CI 1.47–48.47, p = 0.017). Conclusion The cumulative expulsion rate of postpartum IUDs among women delivering at MRRH was low and comparable to expulsion rates in interval insertions. Longer duration from delivery to IUD insertions and longer duration of bloody lochia flow were key risk factors for postpartum IUD expulsion. More emphasis should be put on prenatal counseling for postpartum family planning to allow for postplacental IUD insertions, which are associated with lower expulsion rates.

scholarly journals Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2117
Author(s):  
Lukas Jennewein ◽  
Dörthe Brüggmann ◽  
Kyra Fischer ◽  
Florian J. Raimann ◽  
Hemma Roswitha Pfeifenberger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Upright Position ◽  
Morbidity Rate ◽  
National Guidelines ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Vaginal Deliveries ◽  
Manual Assistance

Background: Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians’ daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management. Methods: We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience. Results: Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008). Conclusions: Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine.

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