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. material and methods: A randomized controlled study was conducted at tertiary care hospital (Tanta University Hospital) in the period from Jan, 1, 2017 to December, 31, 2017.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 and group II was subjected to interval IUD insertion (3 months after cesarean delivery). 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 6 months was 5.88% in study group compared to 8.33% in the control group. The satisfaction rate 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 3.92% in study group and 4.17% in control group with p.value =0.949. Conclusion:Post-placental IUD insertion was found to be a sound, safe and effective clinical approach taking advantages of the possible desire of patients for immediate contraception , so achieving the right goal of pregnancy spacing and decreasing unintended pregnancies.