PDF(Pubmed)
Abstract：
This article aims to report the comprehensive and up-to-date analysis and evidence of the insertion rate, expulsion rate, removal rate, and utilization rate of immediate placement of intrauterine devices (IUDs) versus delayed placement after artificial abortion. PubMed, Embase, Cochrane, Web of Science, CNKI, and Wanfang databases were comprehensively searched up to January 12, 2024 for studies that compared immediate versus delayed insertion of IUDs after abortion. The evaluation metrics included the number of IUD insertion after surgical or medical abortions, the frequency of expulsion and removal at 6 months or 1 year, the number of continued usage, pain intensity scores, the number of infections, the duration of bleeding, and instances of uterine perforation during or after IUD insertion. Ten randomized controlled articles were eligible, comprising 11 research projects, of which 3 projects involved the placement of an IUD after surgical abortion, and 8 projects involved the placement of an IUD after medical abortion. This included 2025 patients (977 in the immediate insertion group and 1,048 in the delayed insertion group). We summarized all the extracted evidence. The meta-analysis results indicated that for post-surgical abortions, the immediate insertion group exhibited a higher IUD placement rate than the delayed insertion group. After medical abortions, the immediate insertion group showed higher rates of IUD placement, utilization, and expulsion at 6 months or 1 year. The two groups showed no statistically significant differences in the removal rate, post-insertion infection rate, pain scores during insertion, and days of bleeding during the follow-up period. Compared to delayed placement, immediate insertion of IUDs can not only increase the usage rate at 6 months or 1 year but also enhance the placement rate.
摘要：
本文旨在报告插入率的全面和最新的分析和证据，驱逐率，去除率，人工流产后立即放置宫内节育器（IUD）与延迟放置的使用率。PubMed,Embase,科克伦,WebofScience,CNKI,截至2024年1月12日，对万方数据库进行了全面搜索，以比较流产后立即插入宫内节育器与延迟插入宫内节育器的研究。评估指标包括手术或药物流产后插入宫内节育器的数量，6个月或1年驱逐和驱逐的频率，继续使用的次数，疼痛强度评分,感染的数量，出血的持续时间,以及宫内节育器插入期间或之后子宫穿孔的实例。十篇随机对照文章符合条件，包括11个研究项目，其中3个项目涉及手术流产后放置宫内节育器，8个项目涉及药物流产后放置宫内节育器。这包括2025名患者（立即插入组977名，延迟插入组1,048名）。我们总结了所有提取的证据。荟萃分析结果表明，对于术后流产，立即插入组的IUD放置率高于延迟插入组。医疗流产后,立即插入组显示出更高的宫内节育器放置率，利用率，并在6个月或1年时被驱逐。两组拔除率差异无统计学意义，插入后感染率，插入过程中的疼痛评分，以及随访期间出血天数。与延迟放置相比，立即插入宫内节育器不仅可以提高6个月或1年的使用率，还可以提高放置率。
