Insersi IUD Pascapersalinan: Dini VS Ditunda

Oleh :

dr. Regina Putri Apriza

Intrauterine device (IUD) dapat dipasang dini setelah persalinan ataupun ditunda. IUD merupakan metode kontrasepsi yang sering direkomendasikan bagi wanita pascapersalinan karena efikasinya yang tinggi dalam mencegah kehamilan.[1]

Pada periode postpartum, penundaan pemasangan kontrasepsi sering ditemukan. Padahal, pemasangan kontrasepsi setelah melahirkan dapat membantu memanjangkan interval antar kehamilan yang bermanfaat dalam meningkatkan kesehatan ibu dan bayi. Mencegah kehamilan yang tidak direncanakan dengan menggunakan kontrasepsi akan membantu menghindari beban finansial, psikologi, dan kesehatan yang tidak perlu.[2]

Interval antar kehamilan yang lebih panjang juga dapat menurunkan risiko komplikasi maternal, termasuk kematian, perdarahan postpartum, endometritis puerperal, dan anemia. Panduan WHO merekomendasikan jarak kehamilan setidaknya 24 bulan dengan tujuan menurunkan luaran buruk maternal dan kesehatan bayi.[2]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Sothornwit J, Werawatakul Y, Kaewrudee S, Lumbiganon P, Laopaiboon M. Immediate versus delayed postpartum insertion of contraceptive implant for contraception. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD011913
2. Lopez LM, Bernholc A, Hubacher D, Stuart G, Vliet HA. Immediate postpartum insertion of intrauterine device for contraception. Cochrane Database of Systematic Reviews 2015, Issue 6
3. WHO. Rekomendasi praktik terpilih pada penggunaan kontrasepsi. Edisi 3. 2016
4. Dirjen Bina Pelayanan Medik Kementrian Kesehatan Republik Indonesia. KB pada periode menyusui. Juni 2010.
5. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 121: Long‐acting reversible contraception: Implants and intrauterine devices. Obstetrics and Gynecology 2011;118(1):184‐96.
6. Trussell J, Henry N, Hassan F, Prezioso A, Law A, Filonenko A. Burden of unintended pregnancy in the United States: potential savings with increased use of long-acting reversible contraception. Contraception 2013;87:154–61, Peipert JF, Madden T,
7. Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol 2012;120:1291–7.
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9. Dahlke JD, Terpstra ER, Ramseyer AM, Busch JM, Rieg T, Magann EF. Postpartum insertion of levonorgestrel–intrauterine system at three time periods: a prospective randomized pilot study. Contraception 2011;84:244–8
10. Hayes JL, Cwiak C, Goedken P, Zieman M. A pilot clinical trial of ultrasound-guided postplacental insertion of a levonorgestrel intrauterine device. Contraception 2007;76: 292–6
11. Celen S, Sucak A, Yildiz Y, Danisman N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section. Contraception 2011;84:240–3
12. Eroglu K, Akkuzu G, Vural G, Dilbaz B, Akin A, Taskin L, et al. Comparison of efficacy and complications of IUD insertion in immediate postplacental/early postpartum period: with interval period 1 year follow-up. Contraception. 2006;74:376-81
13. Chen BA, Reeves MF, Creinin MD, Schwarz EB. Postplacental or delayed levonorgestrel intrauterine device insertion and breast-feeding duration. Contraception 2011;84:499–504
14. Levi EE, Stuart GS, Zerden ML, Garrett JM, Bryant AG. Intrauterine device placement during cesarean delivery and continued use 6 months postpartum: a randomized controlled trial. Obstet Gynecol 2015;126:5–11
15. Lanzola EL, Ketvertis K. Intrauterine Device. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK557403/
16. Whitaker AK, Chen BA. Society of family planning guidelines: postplacental insertion of intrauterine devices. Contraception. 2018;2-13
17. Armstrong MA, Raine-Bennett T, Reed SD, Gatz J, Getahun D, S et al. Association of the Timing of Postpartum Intrauterine Device Insertion and Breastfeeding With Risks of Intrauterine Device Expulsion. JAMA Netw Open. 2022 Feb 1;5(2):e2148474. doi: 10.1001/jamanetworkopen.2021.48474. PMID: 35226086; PMCID: PMC8886522.
18. Ramos-Rivera M, Averbach S, Selvaduray P, Gibson A, Ngo LL. Complications after interval postpartum intrauterine device insertion. Am J Obstet Gynecol. 2022 Jan;226(1):95.e1-95.e8. doi: 10.1016/j.ajog.2021.08.028. Epub 2021 Aug 28. PMID: 34461075; PMCID: PMC8940222.