Intracesarean Postpartum Insertion of Intrauterine Contraceptive Device as an Alternative to Delayed Insertion: Safety and Complications

Al-Mahmoudi, Ahmed Hisham Ahmed; Abdelmoaty, Muhamed Ahmed; Mohamed, Mofeed Fawzy

doi:10.21608/ijma.2022.137234.1461

Intracesarean Postpartum Insertion of Intrauterine Contraceptive Device as an Alternative to Delayed Insertion: Safety and Complications

Document Type : Original Article

Authors

¹ Department of Obstetrics and Gynecology; Isis Specialized Hospital, Luxor, Egypt

² Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

10.21608/ijma.2022.137234.1461

Abstract

Background: Family planning [FP] describes the proper spacing and prevention of unintended pregnancies and seems to improve the couples’ quality of reproductive and overall life. Different modalities are available to achieve such goal.
Aim of the work: This work aimed to evaluate the safety and efficacy profile of postpartum intrauterine contraceptive device [IUCD]. Thus, it could be recommended as a reasonable and effective modality for the family planning.
Patients and methods: A randomized controlled study that included 120 pregnant females, selected from the Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University [Egypt]. All females were clinical evaluated by inquiry about their personal, medical, obstetric and contraception history. This was followed by general and local examination. An abdominal ultrasound was carried out for all. Females of Group-I underwent lower segment cesarean section by standard technique followed by IUD insertion after placental delivery. In the other group, the insertion was done 3 months after delivery. The successful IUD insertion and expulsion rate represented the primary outcome. The secondary outcomes included pregnancy, perforation and other adverse events.
Result: Female’s age ranged between 18 and 37 years and previous cesarean section was the commonest indication of CS. The expulsion rate at 3 and 6 months after insertion was higher for group I than group II. However, the difference was non-significant. In addition, there was no significant differences found between groups I and II regarding post-CS complications at 3 or 6 months after CS. The frequency of pain and bleeding in the follow up duration was statistically increased in Group I than Group II after 3month and after 6 months.
Conclusion: Interval insertion of the IUD is an easy, safe, and effective method and could replace the post-placental insertion. Additionally, it could be the first line contraceptive agent in eligible patients.

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