Abstract
Objective
To evaluate infectious outcomes following postplacental intrauterine device (PPIUD)
placement in patients with suspected chorioamnionitis.
Study design
This retrospective cohort study identified individuals desiring PPIUD who subsequently
developed suspected chorioamnionitis, treated with antibiotics. We followed 12-month
infectious outcomes amongst two cohorts: (1) those who received PPIUD and (2) those
with placement deferred.
Results
Of 55 followed, 18 of 22 PPIUDs were placed before chorioamnionitis was suspected;
33 placements were deferred. Neither group experienced acute infectious complications.
Notably, IUDs were more often deferred when chorioamnionitis was more clearly diagnosed
(20/33, 60.6% vs 4/22, 18.2% p < 0.01). Overdiagnosis of chorioamnionitis prevented IUD uptake in 10 of 55 (18.2%)
individuals in this sample.
Conclusions
PPIUD placement in individuals with early signs of chorioamnionitis may not result
in severe morbidity, in a study limited by sample size. Larger, prospective studies
are needed in well-defined cohorts.
Implications
Incidental, immediate postplacental IUD placement in individuals with treated, suspected
chorioamnionitis was not associated with severe morbidity within 1-year postpartum.
Larger-scale, prospective studies are needed to guide the management of incidentally-placed,
postplacental IUDs in the setting of mild chorioamnionitis.
Keywords
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References
- US medical eligibility criteria for contraceptive use, 2016.MMWR Recomm Rep. 2016; 65 (Published 2016 Jul 29): 1-103https://doi.org/10.15585/mmwr.rr6503a1
- Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: Summary of a workshop.Obstet Gynecol. 2016; 127: 426-436https://doi.org/10.1097/AOG.0000000000001246
- Society of family planning guidelines: Postplacental insertion of intrauterine devices.Contraception. 2018; 97: 2-13https://doi.org/10.1016/j.contraception.2017.09.01
- Maternal leukocytosis after antenatal corticosteroid administration: A systematic review and meta-analysis.J Obstet Gynaecol. 2018; 38 (Epub 2017 Sep 14. PMID: 28903611): 210-216https://doi.org/10.1080/01443615.2017.1342614
- Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
Redcap Project. http://project-redcap.org. (Access date Jan 1, 2020).
- Clinical chorioamnionitis and histologic placental inflammation.Obstet Gynecol. 1999; 94: 1000-1005https://doi.org/10.1016/s0029-7844(99)00416-0
- The changing perinatal and maternal outcome in chorioamnionitis.Obstet Gynecol. 1979; 53: 730-734
- Risk factors for intraamniotic infection: A prospective epidemiologic study.Am J Obstet Gynecol. 1989; 161: 562-568https://doi.org/10.1016/0002-9378(89)90356-6
- Family planning in the immediate postpartum period.Stud Fam Plann. 1973; 4: 33-35
Article info
Publication history
Published online: December 02, 2022
Accepted:
November 18,
2022
Received in revised form:
November 18,
2022
Received:
March 22,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
