OB/GYN Clinical Alert – March 1, 2022
March 1, 2022
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Is the Timing of Interval Postpartum Insertion of Intrauterine Device Associated with the Frequency of Complications?
Having an intrauterine device (IUD) inserted at four to eight weeks postpartum was associated with higher frequency of uterine perforation, but not higher frequency of expulsion, compared to IUD insertion at nine to 36 weeks postpartum. Overall, perforation and expulsion rates were low.
In this retrospective cohort study of 1,236 women, the rate (2.2%) of ectopic pregnancy was rare among women with a fluid collection (or pseudosac) in the uterus. The size of the fluid collection was not predictive of ectopic pregnancy. The presence of an intrauterine fluid collection decreased the risk of ectopic pregnancy (adjusted relative risk, 0.09; 95% confidence interval, 0.05-0.19) after adjusting for age and the presence of bleeding.
Compared to oral iron, intravenous iron reduced maternal anemia at delivery (40% vs. 85%, P = 0.039), and rates of maternal hemoglobin < 10 g/dL were lower with intravenous iron compared to oral iron (10% vs. 54%, P = 0.029). Rates of mild to moderate adverse events were similar between the two groups, and no severe adverse reactions were noted with intravenous iron.
This study demonstrated an increased risk of neonatal hypoglycemia in neonates born to patients with diabetes as the result of maternal hyperglycemia in labor. However, strict intrapartum maternal glycemic control appeared to be associated with a reduced risk of neonatal hypoglycemia only in patients with gestational diabetes on medication, but not for other diabetes subtypes.