{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:29Z","timestamp":1790390729627,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T00:00:00Z","timestamp":1537228800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FIGO initiative funded by anonymous donors"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To record and analyze complication rates following postpartum intrauterine device (<jats:styled-content style=\"fixed-case\">PPIUD<\/jats:styled-content>) insertion in 48 hospitals in six countries: Sri Lanka, India, Nepal, Bangladesh, Tanzania, and Kenya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthcare providers were trained in counselling and insertion of <jats:styled-content style=\"fixed-case\">PPIUD<\/jats:styled-content> via a training\u2010the\u2010trainer model. Data were collected on methodology, timing, cadre of staff providing care, and number of insertions. Data on complications were collected at 6\u2010week follow\u2010up. Statistical analysis was performed to elucidate factors associated with increased expulsion and absence of threads.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From May 2014 to September 2017, 36\u00a0766 <jats:styled-content style=\"fixed-case\">PPIUD<\/jats:styled-content>s were inserted: 53% vaginal and 47% at cesarean delivery; 74% were inserted by doctors. Follow\u2010up was attended by 52%. Expulsion and removal rates were 2.5% and 3.6%, respectively. Threads were not visible in 29%. Expulsion was less likely after cesarean insertion (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 0.33; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.26\u20130.41), following vaginal insertion at between 10\u00a0minutes and 48\u00a0hours (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 0.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.42\u20130.83), and when insertion was performed by a nurse (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 0.33; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.22\u20130.50).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">PPIUD<\/jats:styled-content> has low complication rates and can be safely inserted by a variety of trained health staff. Given the immediate benefit of the one\u2010stop approach, governments should urgently consider adopting this model.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12600","type":"journal-article","created":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T07:29:51Z","timestamp":1537255791000},"page":"20-27","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["<scp>FIGO<\/scp> postpartum intrauterine device initiative: Complication rates across six countries"],"prefix":"10.1002","volume":"143","author":[{"given":"Anita","family":"Makins","sequence":"first","affiliation":[{"name":"International Federation Gynecology and Obstetrics  London UK"},{"name":"Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Taghinejadi","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Sethi","sequence":"additional","affiliation":[{"name":"International Federation Gynecology and Obstetrics  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyo","family":"Machiyama","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Projestine","family":"Munganyizi","sequence":"additional","affiliation":[{"name":"Association of Gynaecologists and Obstetricians of Tanzania  Dar es Salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elly","family":"Odongo","sequence":"additional","affiliation":[{"name":"Kenya Obstetrical and Gyanecological Society  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hema","family":"Divakar","sequence":"additional","affiliation":[{"name":"Federation of Obstetric and Gynecological Societies of India  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parveen","family":"Fatima","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Department Bangabandhu Sheikh Mujib Medical University  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kusum","family":"Thapa","sequence":"additional","affiliation":[{"name":"Nepal Society of Obstetricians and Gynaecologists  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gamini","family":"Perera","sequence":"additional","affiliation":[{"name":"Sri Lanka College of Obstetricians and Gynaecologists  Colombo Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabaratnam","family":"Arulkumaran","sequence":"additional","affiliation":[{"name":"International Federation Gynecology and Obstetrics  London UK"},{"name":"St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2009.00206.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2015.03.008"},{"key":"e_1_2_9_4_1","volume-title":"Medical Eligibility Criteria for Contraceptive Use","author":"World Health Organization","year":"2015"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2012.00302.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2015.12.012"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.04.017"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-15-00355"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2009.03.024"},{"issue":"6","key":"e_1_2_9_11_1","first-page":"CD003036","article-title":"Immediate postpartum insertion of intrauterine device for contraception","author":"Lopez LM","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.07.003"},{"key":"e_1_2_9_13_1","unstructured":"Laerdal[website].Mama\u2010U Postpartum Uterus Trainer[Internet].https:\/\/laerdalglobalhealth.com\/products\/mama-u\/. 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