Further Support for Same-Day Intrauterine Device Placement

Current CDC guidelines support intrauterine device (IUD) placement whenever a clinician is reasonably sure the woman is not pregnant. As an aid in determining pregnancy risk, use of a six-item checklist has been promoted. To evaluate the effects of this checklist on IUD placement in clinical practice, researchers analyzed data collected from two practices that routinely place the levonorgestrel-releasing intrauterine system (LNG-IUS [Mirena]) after a negative pregnancy test but without referring to the checklist.

Adherence to the checklist would have prevented same-day LNG-IUS placement for 40% of patients. However — with or without use of the checklist — luteal phase pregnancy occurred following <1% of placements.