Abstract

INTRODUCTION: Immediate postabortion intrauterine device (IUD) placement has been shown to be safe and is effective in decreasing repeat abortion. Data are available to counsel patients on expulsion, perforation, and infection; however, little has been reported about immediate postoperative pain and recovery after postabortion IUD insertion. METHODS: We performed a retrospective cohort study to compare the immediate postoperative experience of patients who had postabortion IUDs placed (n=250) matched for gestational age and type of anesthesia with patients who did not have IUDs placed (n=250). The primary outcome was postabortion pain on a 0–10 scale approximately 20 minutes after the procedure. Secondary outcomes included pain score before discharge, length of stay in the recovery room, use of pain medication, and complications. RESULTS: Of the 500 records reviewed, 461 met inclusion criteria. We found no difference in the mean 20-minute pain score between women who received an IUD postabortion and those who did not (4.1 compared with 3.9, P=.50). Pain score at discharge, use of additional pain medication, and complication rates were low and not statistically different between groups. The non-IUD group spent longer in the recovery room (57 compared with 53 minutes, P=.04). Stratified analysis by gestational age and type of anesthesia and multivariate regression were performed. Pain scores between the groups remained comparable. CONCLUSIONS: We found no evidence that placing an IUD postabortion results in a higher postoperative pain score or longer stay in the recovery room. The average pain score reported by both groups was low.

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