Evaluation of Post-Placental IUD Insertion during Cesarean Section at a Tertiary Care Hospital in Egypt

Abstract

Objectives: To evaluate the efficacy of post placental IUD insertion during cesarean section. Background: IUD could be applied to the female after delivery of placenta during cesarean section, it had many advantages as the female is under anesthesia so no extra manipulation needed, decrease pain, and also the female at the period of delivery had high motive for family planning. Post placental IUD insertion also had many disengages like bleeding and displacement. Material and methods: A randomized controlled study was conducted at tertiary care hospital (Tanta University Hospital) in the period from Jan, 1, 2017 to May 31 2019. Two groups of patients were selected; each group included 60 patients with desire of birth control. The group I was subjected to post-placental intrauterine device (IUD) insertion during cesarean section and group II was subjected to interval IUD insertion (3 months after cesarean delivery). The type of IUD used was cupper-T IUD, both groups were assessed as regard to time of cesarean section (CS), amount of postoperative bleeding, postoperative pain, occurrence of infection, any displacement of IUDs, failure of contraception and patients' satisfaction. Results: The demographic data were comparable in both groups. The duration of cesarean surgery was slightly prolonged in the study group. The infection, puerperal bleeding, and displacement of IUDs were not significantly different in both groups. The discontinuation rate after 12 months was 13.72% in study group compared to 16.66% in the control group. The satisfaction rates in both groups were 90.20%, 91.67% in study and control groups respectively. The expulsion rates were 3.92% and 0.00% in the study and control groups respectively. Pregnancy on top of IUD was 1.96% in study group and 4.17% in control group with p value = 0.949. Conclusion: Post-placental IUD insertion is found to be safe, easily applied during cesarean section with slight prolongation of cesarean section duration. Post-placental IUD insertion

Hang-up Technique versus Non-fixation Technique for Immediate Post-placental IUD Insertion during Cesarean Section: A Randomized Controlled Trial

“…In this trial, only one case was reported with IUD displacement (rotational) in the non-fixation group where the transverse limbs of IUD were moved towards cervix (1.8%) but no cases reported in hang up technique group. In agreement with our study, Elsokary et al (24) compared IUD placement during CS and IUD placement 3 months postpartum found that IUD displacement in the intracesarean IUD insertion group was 1.9%. In contrast to our study, Ragab et al (9) found that the displacement rate was 28%, but this study used 3 different types of IUDs.…”

“…Another study, where CU T 380A insertion was done with the non-fixation technique during CS, revealed that about 10.6 % of patients had menorrhagia after 1 year (20) . A study by Elsokary et al (24) reported that the percentage of patients with abnormal uterine bleeding after 1 year of IUD insertion during CS was 9.8%. Tjahjanto and Haryuni (10) reported that abnormal uterine bleeding after 1 year was detected in 5.6% of the included patients.…”

Socio-Demographics and Contraceptive Acceptance of Women of Reproductive Age in Peshawar Pakistan: A Cross-sectional Study

“…In developing countries, more than 100 million women would like to space their pregnancies, but they might not be using any sort of contraception due to their own reasons, so increasing the unmet needs for contraception (2). Healthcare personnel has many opportunities to interact with a married woman during her reproductive life like antenatal, intrapartum, and postpartum period (3). Contraception in immediate postpartum period is now becoming popular as this may be the woman's only contact with health care services (4).…”

Evaluation of IUD Insertion During CS In 100 Patient. A Prospective Study

“…Theoretically, when IUDs are placed at the time of cesarean delivery, the cervix is frequently not fully dilated, making it more difficult for the IUD to be expelled through the cervical canal. Additionally, it is technically easier to achieve appropriate fundal placement of the IUD during cesarean delivery because the entire uterus can be visualized, palpated, and manually explored within the surgical field [5]. Immediate intra-caesarean IUD insertion after placental delivery provides changeable and efficient long-term contraceptive that does not interfere with lactation.…”