title: Postpartum insertion of levonorgestrel--intrauterine system at three time periods: a prospective randomized pilot study.
abstract: BACKGROUND
  The study was conducted to determine the feasibility of levonorgestrel-intrauterine system (LNG-IUS) insertion at three different times postpartum.
  
  
  METHODS
  From August 2009 to January 2010, all women desiring LNG-IUS for postpartum contraception were offered enrollment into our study and randomized to three insertion times: immediate (within 10 min of placenta delivery), early (10 min to 48 h postpartum) or interval (≥6 weeks postpartum).
  
  
  RESULTS
  Forty-six women met inclusion criteria and were analyzed. There was no difference in utilization rates at 3 and 6 months between groups (p=.931). Expulsion rates were significantly higher and pain during insertion was significantly lower in the immediate and early groups (p<.001) when compared to the interval group.
  
  
  CONCLUSIONS
  Insertion of LNG-IUS ≤48 h postpartum is feasible in our institution and may be associated with similar utilization at 6 months, increased expulsion rates and decreased pain at insertion when compared to placement after 6 weeks.
authors.affiliation: Department of Obstetrics and Gynecology, The Naval Medical Center Portsmouth, VA 23708, USA. joshua.dahlke@med.navy.mil
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Dahlke
authors.forename: Eric R
authors.initials: ER
authors.lastname: Terpstra
authors.forename: Abigail M
authors.initials: AM
authors.lastname: Ramseyer
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Busch
authors.forename: Thomas
authors.initials: T
authors.lastname: Rieg
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007436:Intrauterine Devices, Medicated; D016912:Levonorgestrel / Q000008:administration & dosage*; D010865:Pilot Projects; D049590:Postpartum Period; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D016912:Levonorgestrel