Consensus of best practice in intrauterine contraception in France

Eur J Contracept Reprod Health Care. 2019 Aug;24(4):305-313. doi: 10.1080/13625187.2019.1625325. Epub 2019 Jun 17.

Abstract

Objective: Our aim was to provide a consensus of best practice in intrauterine contraception (IUC) for French practitioners. Methods: A meeting of 38 gynaecologists was held to establish a consensus of best practice in IUC, using the validated nominal group (NG) method to reach consensus. Seventy questions were posed covering insertion, monitoring and removal of IUC devices. Two working groups were formed and all proposals were voted on, discussed and approved by the NG. Results: Of the 70 questions asked, answers to only four failed to reach NG consensus. While, in general, the IUC practices of French gynaecologists are in line with international guidelines, some notable differences were identified: for example, when to use the levonorgestrel-releasing intrauterine system versus the copper intrauterine device; practice recommendations in the event of upper genital tract infections; and immediate postpartum insertion. Clinicians are encouraged to inform women about IUC, irrespective of their age or parity. In general, the wishes and characteristics of the woman must be the main criteria informing the choice of IUC, once all potential contraindications have been excluded and information about IUC shared. Conclusions: This consensus paper is intended to update and standardise knowledge about IUC for health care professionals, to address any reticence about use of this contraceptive method.

Keywords: Consensus; copper; intrauterine contraception; levonorgestrel; nulliparous.

Publication types

  • Review

MeSH terms

  • Consensus
  • Female
  • France
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Intrauterine Devices* / adverse effects
  • Intrauterine Devices* / standards
  • Midwifery
  • Physicians / psychology*
  • Practice Guidelines as Topic*