@article{76e54553cffd43caa942382e3667826a,
title = "Post-placental intra-abdominal placement of levonorgestrel 52 mg intrauterine system: A case report",
author = "Jose Carugno",
note = "Funding Information: I have read with great interest the case report published by Peterson et al. entitled “Post-placental intra-abdominal placement of levonorgestrel 52 mg intrauterine system: A case report” [1] . Uterine perforation, when placing an intrauterine device (IUD) immediately after delivery of the placenta, is an extremely rare event with only 1 case reported in the literature, and it is not clear if in that case, the perforation happened at the time of insertion [2] . Immediate postpartum insertion of IUD is supported by the American College of Obstetrics and Gynecology ACOG as best practice in contraception [3] . In the absence of chorioamnionitis, which is a contraindication of post-placental IUD insertion, the physiologic contractions of the myometrium immediately after the delivery of the placenta, give the uterus a hard consistency which makes uterine perforation at the time of placing an IUD almost impossible, especially if the IUD was held in the physician{\textquoteright}s hand, as in this case, and not using a ring forceps. The authors speculate that the reason why the IUD was found in the abdominal cavity was likely a result of trauma to the posterior fundal aspect of the uterus at the time of insertion. ",
year = "2020",
month = sep,
doi = "10.1016/j.contraception.2020.04.020",
language = "English (US)",
volume = "102",
pages = "222--223",
journal = "Contraception",
issn = "0010-7824",
publisher = "Elsevier USA",
number = "3",
}