{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:43:15Z","timestamp":1781120595966,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2017,8,2]],"date-time":"2017-08-02T00:00:00Z","timestamp":1501632000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Hospital District of Helsinki and Uusimaa"},{"name":"The Finnish Cultural Foundation and Finnish-Norwegian Medical Foundation"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n Objective<\/jats:title>\n \n To assess the 1\u2010year continuation rates and new pregnancies following immediate versus delayed insertion of the levonorgestrel\u2010releasing intrauterine system (\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n ) after medical termination of pregnancy (\n MTOP<\/jats:styled-content>\n ) up to 20\u00a0weeks of gestation.\n <\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n A randomised controlled trial.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Helsinki University Hospital, Finland, January 2013 to December 2014.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n \n A total of 267 women requesting\n MTOP<\/jats:styled-content>\n and planning\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n for post\u2010\n MTOP<\/jats:styled-content>\n contraception.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Insertion of\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n occurred immediately (0\u20133\u00a0days) or after a delay (2\u20134\u00a0weeks) following\n MTOP<\/jats:styled-content>\n . Follow\u2010up visits were at 3\u00a0months and 1\u00a0year after\n MTOP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n use at 1\u00a0year after\n MTOP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Women were randomised to immediate (\n n<\/jats:italic>\n \u00a0=\u00a0134) or delayed (\n n<\/jats:italic>\n \u00a0=\u00a0133) insertion of the\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n , and 133 and 131 were analysed; 127 (95.5%) women received immediate insertion and 111 (84.7%) women had delayed insertion of the\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n (risk ratio [\n RR<\/jats:styled-content>\n ] 1.13, 95%\n CI<\/jats:styled-content>\n 1.04\u20131.22). The verified numbers of women continuing the\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n use at 1\u00a0year were 83 (62.4%) and 52 (39.7%) (\n RR<\/jats:styled-content>\n 1.57, 95%\n CI<\/jats:styled-content>\n 1.23\u20132.02). The numbers of new pregnancies were 6 (4.5%) and 16 (12.2%) (\n RR<\/jats:styled-content>\n 0.37, 95%\n CI<\/jats:styled-content>\n 0.15\u20130.91), and numbers of subsequent\n TOP<\/jats:styled-content>\n s\u00a0were 4 (3.0%) and 5 (3.8%) (\n RR<\/jats:styled-content>\n 0.79, 95%\n CI<\/jats:styled-content>\n 0.22\u20132.87).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Immediate insertion of the\n LNG<\/jats:styled-content>\n \u2010\n IUS<\/jats:styled-content>\n following\n MTOP<\/jats:styled-content>\n resulted in higher 1\u2010year continuation rates compared with delayed insertion. In addition, those receiving immediate insertion demonstrated a decreased new pregnancy rate, but no difference in the numbers of another\n TOP<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Tweetable abstract<\/jats:title>\n Immediate LNG\u2010IUS insertion after MTOP results in a higher 1\u2010year continuation compared with delayed insertion.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.14802","type":"journal-article","created":{"date-parts":[[2017,6,26]],"date-time":"2017-06-26T10:54:39Z","timestamp":1498474479000},"page":"1957-1964","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Immediate versus delayed initiation of the levonorgestrel\u2010releasing intrauterine system\u00a0following medical termination of pregnancy \u2013\u00a01\u00a0year continuation rates: a randomised controlled trial"],"prefix":"10.1111","volume":"124","author":[{"given":"R","family":"Korjamo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Mentula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,2]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"UNDP\/UNFPA\/WHO\/World Bank Special Programme of Research Development and Research Training in Human Reproduction (HRP).Safe and unsafe induced abortion \u2010 Global and regional levels in 2008 and trends during 1995\u20132008. 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