Same-day IUD placement OK for women at high risk of STI

May 1, 2014

Concerns about asymptomatic sexually transmitted infection (STI) in women at high risk should not delay placement of an intrauterine device (IUD) in women who also are at risk of undesired pregnancy, according to a study by investigators from the University of Pittsburgh. The results, in 366 patients from an inner-city clinic, were presented at the 2014 ACOG Annual Clinical Meeting.

 

Concerns about asymptomatic sexually transmitted infection (STI) in women at high risk should not delay placement of an intrauterine device (IUD) in women who also are at risk of undesired pregnancy, according to a study by investigators from the University of Pittsburgh. The results, in 366 patients from an inner-city clinic, were presented at the 2014 ACOG Annual Clinical Meeting.

In the study, surveys were administered at a clinic that offered same-day testing for STIs and IUD placement to all patients who wanted emergency contraception or pregnancy testing and who were negative for cervicitis and wanted to avoid pregnancy for more than 6 months. The questionnaires-about contraceptive use and STI testing, diagnosis, and treatment-were completed by 366 women on the day of their clinic visit and 3 months later between September 2011 and May 2013. Twenty-eight of those who completed the surveys opted for same-day IUD placement.

[See also Leveraging Long-Acting Reversible Contraceptives (LARC)]

Rates of pelvic inflammatory disease (PID) within 3 months of visiting the clinic were similar with same-day IUD placement (5.3%, 95% CI 3.0-8.5%, P=.82). Three months later, 82% of the women who opted for same IUD placement were still using the devices. Pregnancy within 3 months of visiting the clinic was reported by 3.6% of those who opted for same-day IUD placement, versus 10.7% of others compared with a clinic-wide rate of 11% before change in clinic policy.

[Guidelines Blur Treatment Decisions for PID]

Routine counseling about IUDs with an offer of same-day device placement, the authors said, appears to have reduced rates of undesired pregnancy without increasing rates of PID among women at high risk of STI and unwanted pregnancy.

 

Wang NA, Papic M, Parisi SM, et al. Same-day placement of intrauterine contraception for high-risk women. Obstet Gynecol. 2014;123(5):15S


 

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