{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T06:43:46Z","timestamp":1786171426242,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","award":["SLS\u2010692651"],"award-info":[{"award-number":["SLS\u2010692651"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["LS\u20102016\u20101376"],"award-info":[{"award-number":["LS\u20102016\u20101376"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["RS 2019\u20101054"],"award-info":[{"award-number":["RS 2019\u20101054"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["K 0138\u20102015"],"award-info":[{"award-number":["K 0138\u20102015"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["LS 2018\u20101257"],"award-info":[{"award-number":["LS 2018\u20101257"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Intrauterine devices (IUDs) effectively prevent unwanted pregnancies. Little is known about long\u2010term outcomes of women choosing an IUD after second\u2010trimester medical abortion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>\n                      We performed a 12\u2010month follow\u2010up of a multicenter randomized controlled trial comparing IUD placement within 48\u2009h (intervention) with placement at 2\u20134\u2009weeks (control) after medical abortion with 85 to 153\u2009days' gestation. Secondary outcomes such as proportions of long\u2010term IUD use, subsequent pregnancies and abortions, and participant satisfaction are presented (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      NCT03603145).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 179 women were included. The 12\u2010month follow\u2010up rate was 71.1% (64\/90) in the intervention group and 73.0% (65\/89) in the control group. Fewer women in the intervention group were using an IUD after 12\u2009months: 51.6% (33\/64) vs. 69.2% (45\/65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). The total expulsion rate over 12\u2009months was 36.4% (24\/66) in the intervention group compared to 3.1% (2\/65) in the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with only two IUDs being expelled between 6 and 12\u2009months, both in the intervention group. The most common contraceptive method at 12\u2009months was any hormonal IUD at 54.3% (70\/129). Among IUD users at 12\u2009months, the overall satisfaction with their contraceptive method was high, at 88.3% (68\/77). In the intervention group, 26.2% (16\/61) had at least one subsequent pregnancy within 12\u2009months compared to 13.6% (9\/66,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08) in the control group. We found no significant difference in the number of subsequent abortions; 13.1% (8\/61) in the intervention group and 6.1% (4\/66) in the control group reported at least one subsequent abortion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.23).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Immediate IUD placement after second\u2010trimester medical abortion did not lead to a higher proportion of IUD use at 12\u2009months compared to delayed placement. Rather, immediate IUD placement was associated with a higher incidence of expulsion and lower use; however, no significant increase in subsequent pregnancies or abortions was observed. High satisfaction levels with IUD use were reported in both groups, but women with immediate placement were less likely to recommend a friend to use an IUD post abortion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70259","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:21:24Z","timestamp":1781079684000},"page":"1672-1679","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immediate placement of intrauterine device after second\u2010trimester medical abortion\u2014Secondary outcomes with one\u2010year follow\u2010up"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6061-3982","authenticated-orcid":false,"given":"Sara","family":"Hogmark","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"},{"name":"Center for Clinical Research Dalarna, Uppsala University  Falun Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2718-1664","authenticated-orcid":false,"given":"Caroline","family":"Westermark","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Obstetrics and Gynecology Danderyd Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-7642","authenticated-orcid":false,"given":"Niklas","family":"Envall","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"School of Health and Welfare, Dalarna University  Falun Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1444","authenticated-orcid":false,"given":"Kristina","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Division of Gynecology and Reproductive Medicine, WHO\u2010Centre Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Kopp Kallner","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Obstetrics and Gynecology Danderyd Hospital  Stockholm 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