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 is also effective, with few complications compared
to interval IUD insertion. This modality of insertion was accepted by the great
majority of patients being painless and at the same time of surgery with no
added cost or maneuver and utilizing the enthusiasm of patients for immediate
contraception. The continuation rates are good in the study follow up duration.