Immediate postpartum placement of intrauterine devices (IUDs) can help reduce unintended short-interval pregnancy; however, the rate of spontaneous device expulsion is increased. The objective of this study is to evaluate the risk of expulsion with ultrasound-guided placement of immediate postpartum IUDs. Retrospective review of all patients receiving immediate postpartum IUDs after vaginal delivery at Prisma Health Richland Hospital from 2018 to 2020 was performed. Outcomes were available for 78 patients in the ultrasound-guided cohort and for 226 in the control cohort. The expulsion rate was 15.4% (95% CI 8.2-25.3%) for the ultrasound-guided cohort and 14.2% (95% CI 9.9-19.4%) for the control cohort. Our data suggest that using ultrasonography to guide placement of IUDs immediately after vaginal delivery is not associated with the risk of expulsion.
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