Interval insertion of IUDs after induced termination
of pregnancy: do women come back?
Melville, C; McInally, J; Struthers, G; Crombie, A
NHS Ayrshire & Arran, UK
Background: Long-acting reversible contraceptive methods are
recognised as the most effective methods of contraception. Our
termination of pregnancy (TOP) service offers IUD insertion at
the time of surgical TOPs however IUD insertion is not available
at the time of medical TOP. In 2010 we launched a post-TOP
IUD fitting service. Women are offered an appointment 28 days
after their medical procedure in line with FSRH guidance. We
reviewed this service in order to inform future provision and to
determine whether women would return for this appointment.
Methods: A retrospective review of cases was performed using the
electronic patient record (Eclipse) and the ward appointment
diaries. The number of IUD appointments arranged, the number
of patients who attended, and the type of IUD inserted were
collected for the first 12 month period of the service (January–
December 2010).
Results: In the first year of the service, 76 IUD fitting
appointments were made for women after induced TOP. Of these
76, 29 women attended (38%). The DNA (did not attend) rate
was 62%. Nineteen IUS devices were inserted and 10 copper
IUDs.
Conclusion: Although the DNA rate of 62% is high, this is
reflected in other similar services and for other follow up
appointments after induced TOP. Ideally, IUD insertion would be
available at the time of all induced TOPs, however with our
current staffing model this is not possible. To increase attendance
at the IUD service, we recommend using a text reminder service.