Objective asses the safety and efficacy of immediate IUD insertion following delivery of the placenta in women undergoing cesarean delivery. Study: Randomized clinical trial that included 66 women, were divided equally in two arms, where each arm included 33 patients. The first group had IUD inserted 10 min after delivery of the placenta (post placental group) and the second group had their IUD inserted at 6weeks following delivery (interval group). Results The complication rate related to post placental IUD insertion was comparable to that of interval insertion. The expulsion and displacement rates were the same in both post placental and interval groups at 6 weeks and 3 months follow up. Conclusion Post placental IUD insertion is a safe and attractive option for postpartum contraception that should be offered to all women undergoing elective cesarean section after proper counseling.

Objective To compare the efficacy and safety of rectal misoprostol with intrauterine misoprostol in the reduction of blood loss during and after cesarean delivery. Methods Ninety‐eight pregnant women, all candidates for elective cesarean delivery, were equally randomized into two groups: the rectal group (received preoperative misoprostol rectally) and the intrauterine group (received intrauterine misoprostol after the delivery of the placenta). The primary outcome was the estimated blood loss (EBL) during cesarean delivery. Secondary outcomes included the occurrence of excessive blood loss (>1000 mL) within the first 24 hours postoperatively and the occurrence of any maternal or fetal side effects. Results There were no statistically significant differences between the two groups regarding either the EBL (693.12 ± 139.09 vs 692.39 ± 132.83; P=0.979) or the occurrence of postpartum hemorrhage (>1000 mL) (6.1% vs 4.1%; P=0.99. Apgar scores at 1 and 5 minutes were significantly higher in the intrauterine group compared to the rectal group. Conclusion Insertion of intrauterine misoprostol is as effective as rectal insertion in reducing blood loss during and after cesarean delivery; however, it has a safer neonatal outcome and is more convenient when administered during cesarean delivery. ClinicalTrials.gov: NCT03723031.

Objectives : To compare efficacy and safety of the Transradial approach (TRA) with that of the transfemoral approach (TFA) in uterine artery embolization (UAE) for the management of uterine fibroids. Methods: We searched PubMed, SCOPUS, and Web of Science for relevant clinical trials and observational studies. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias of the trials using Cochrane's risk of bias tool. Observational studies were evaluated according to the National Heart, Lung, and Blood Institute (NHLB). Results: We included a total of four studies one of them is a RCT and the others are obsrvitional studies. The pooled analysis showed that TRA was associated with a significant reduction of the procedure time , (P = 0.001). There is no significant difference between both groups regarding the fluoroscopy time (MD= -1.07 [-3.92, 1.78], (P = 0.46), radiation exposure (MD= -0.14 [-0.35, 0.08]), (P = 0.21), major access site complications (OR= 0.66 [0.24, 1.85], (P = 0.43), and minor access site complications (OR= 0.69 [0.33, 1.43]), (P = 0.32). Conclusion:Transradial and transfemoral approaches have the same safety and efficacy but the transradial was associated with a short duration of the procedure.