Postplacental Mirena IUD Insertion and Estimating Expulsion Rates.

December 16, 2021 updated by: Rebecca Hunt

Experimental Study Examining Mirena IUD Insertion and Estimating Rates of Expulsion Immediately After Placental Delivery.

This study aims to demonstrate that the expulsion rate is increased but acceptable when inserting Mirena IUDs immediately postpartum, termed 'postplacental IUD insertion'. The investigators will compare the postplacental insertion expulsion rate estimate with rates reported in the literature for 6 week postpartum insertion, which is currently the American standard for IUD insertion postpartum. Secondary outcomes will also be examined; endometritis, uterine perforation, continuation and pregnancy among others.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

The average expulsion rate for 6 week postpartum IUD insertion is approximately 10-12% with a range between 3-20% at 1 year. An acceptable expulsion rate for postplacental insertion (PPI) has not been defined and varies between studies. There are limited data on the expulsion rates of levonorgestrel intrauterine systems. Expulsion rates range widely from 1-3% to as high as 30-40% depending on the IUD and the study. Studies report an average rate of expulsion in ranges approximating 10-12%, similar to 6 week insertion rates.

There are many limitations to published studies including the use of older model IUDs no longer in use, multiple insertion techniques that have been deemed ineffective in reducing expulsion rates as well as varying follow up times making comparison of expulsion rates difficult.

Study Type

Interventional

Enrollment (Actual)

4

Phase

  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • age 18 or greater
  • obstetric patient in greater Portland, ME area

Exclusion Criteria:

  • Evidence of chorioamnionitis (persistent fetal tachycardia, intra-partum fever >38.0)
  • prolonged rupture of membranes (greater than 24 hours)
  • intrauterine fetal demise
  • use of general anesthesia at time of delivery
  • postpartum hemorrhage (>500ml vaginal, >1000ml cesarean)
  • magnesium administration in labor due to HELLP syndrome or preeclampsia
  • preterm delivery.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mirena IUD Placement Immediately Post-delivery
Participants enrolling in this study agree to have the IUD placed immediately post-delivery versus waiting the standard 6 weeks.
Device: Levonorgestrel Intrauterine Device
levonorgestrel intrauterine device insertion within ten minutes of placental delivery using a ring forceps insertion protocol
Other Names:
  • Mirena

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants Who Expelled IUDs by12 Weeks Postpartum
Time Frame: up to 12 weeks postpartum
Number of participants who expelled IUDs by12 weeks postpartum across all participants
up to 12 weeks postpartum

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rebecca Hunt

Collaborators

MaineHealth

Investigators

  • Principal Investigator: Jennifer J Mueller, MD, MaineHealth

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 7, 2010

Primary Completion (Actual)

October 27, 2010

Study Completion (Actual)

July 26, 2011

Study Registration Dates

First Submitted

October 28, 2010

First Submitted That Met QC Criteria

October 28, 2010

First Posted (Estimate)

October 29, 2010

Study Record Updates

Last Update Posted (Actual)

December 17, 2021

Last Update Submitted That Met QC Criteria

December 16, 2021

Last Verified

December 1, 2021

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 3689

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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