Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

Zaconeta, Alberto Moreno; Oliveira, Ana Carolina; Estrela, Flavielly Souza; Vasconcelos, Thalia Maia; França, Paulo Sérgio; Wanderley, Miriam da Silva; Amato, Angélica Amorim

doi:10.1055/s-0039-1693677

Cited by 6 publications

(5 citation statements)

References 21 publications

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“…Moreover, the same study found no difference between the expulsion rate during the first 6 weeks and in the period between 6 weeks and 6 months. 18…”

Section: Discussionmentioning

confidence: 99%

Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it

Ferreira

Utiyama

Tamanaha

et al. 2022

Rev Bras Ginecol Obstet

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Objective To analyze the profiles of women who accepted and who refused the insertion of the copper intrauterine device (IUD) postpartum and to learn the motivations related to the refusal of the method. Methods Cross-sectional study with 299 pregnant women. The women were informed about the possibility of inserting a copper IUD postpartum and were questioned about their interest in adopting or not this contraceptive. All participants answered a questionnaire with information relevant to the proposals of the present study. The sample size was limited to the number of devices available for the present study. Results A total of 560 women were invited to join the present study and 299 accepted. Out of the 299 women included in the present study, 175 accepted the copper IUD and 124 refused. As the number of pregnancies increased, the IUD acceptance rate raised (p = 0.002), especially between the groups with 1 and with ≥ 4 pregnancies (p = 0.013). Regarding the desire to have more children, the women who planned to have more children were more likely to refuse the method than the ones who did not (p < 0,001). Conclusion Women with multiple pregnancies and desire to not have more children were more likely to accept the copper IUD. The profile of those who refused was first pregnancy and desire to have more children. Among the three most frequent reasons reported for copper IUD rejection, two responses stood out: no specific justification and desire to have more children.

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“…Moreover, the same study found no difference between the expulsion rate during the first 6 weeks and in the period between 6 weeks and 6 months. 18…”

Section: Discussionmentioning

confidence: 99%

Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it

Ferreira

Utiyama

Tamanaha

et al. 2022

Rev Bras Ginecol Obstet

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Section: Methodsmentioning

confidence: 99%

“…In patients undergoing cesarean section, after placental delivery, the IUD was manually inserted at the top of the uterine fundus through the hysterotomy incision; then, the strings were directed to the cervix, without cutting them. 15 In vaginal delivery, the IUD was inserted after delivery, with the uterus spontaneously contracted and before the administration of oxytocin. For the vaginal insertion, a 33-cm curved Kelly forceps was used.…”

Section: Palavras-chavementioning

confidence: 99%

“…5 On the other hand, in view of the available scientific evidence, the postpartum insertion of an IUD is a safe practice with few contraindications and many benefits that can be routinely offered to women, including adolescents. 8,9 However, few studies [15][16][17][18][19] have evaluated the results of this practice in Brazilian public maternities. Thus, our objective was to evaluate the expulsion and continuation rates of copper IUDs inserted in the immediate postpartum period in a Brazilian public university hospital.…”

Section: Introductionmentioning

confidence: 99%

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Immediate Postpartum Insertion of Copper Intrauterine Device in a Brazilian University Hospital: Expulsion and Continuation Rates

Nahas

Magalhães

Bueloni-Dias

et al. 2023

Rev Bras Ginecol Obstet

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Objective To evaluate the expulsion and continuation rates of the copper intrauterine device (IUD) inserted in the immediate postpartum period in a Brazilian public university hospital. Materials and Methods In the present cohort study, we included women who received immediate postpartum IUD at vaginal delivery or cesarean s March 2018 to December 2019. Clinical data and the findings of transvaginal ultrasound (US) scans performed 6-weeks postpartum were collected. The expulsion and continuation rates were assessed 6-months postpartum using data from the electronic medical records or by telephone contact. The primary outcome was the proportion of IUDs expelled at 6 months. For the statistical analysis, we used the Student t-test, the Poisson distribution, and the Chi-squared test. Results There were 3,728 births in the period, and 352 IUD insertions were performed, totaling a rate of 9.4%. At 6 weeks postpartum, the IUD was properly positioned in 65.1% of the cases, in 10.8% there was partial expulsion, and in 8.5% it had been completely expelled. At 6 months postpartum, information was obtained from 234 women, 74.4% of whom used IUD, with an overall expulsion rate of 25.6%. The expulsion rate was higher after vaginal delivery when compared with cesarean section (68.4% versus 31.6% respectively; p = 0.031). There were no differences in terms of age, parity, gestational age, final body mass index, and newborn weight. Conclusion Despite the low insertion rate of copper IUDs in the postpartum period and a higher expulsion rate, the rate of long-term continuation of intrauterine contraception was high, indicating that it is a useful intervention to prevent unwanted pregnancies and to reduce short-interval birth.

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“…The measurement method of “Ultrasonic Diagnosis” of Utility Obstetrics and Gynecology is used in the edge of the fetus to the fetus. The distance > 30 mm is standard [ 8 – 10 ].…”

Section: Methodsmentioning

confidence: 99%

Multi-Indicator Intelligent Monitoring of Clinical Observations to Reduce Cesarean Section

Xie

Dong

Liu

et al. 2021

Contrast Media & Molecular Imaging

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In order to analyze multi-index monitoring and the effect of reducing cesarean section, this paper selects March 2018 and March 2019 in two obstetrics and gynecology hospitals, referred to as hospital A and hospital B. As research objects, 313 pregnant women were divided into multi-index group and conventional group, while analyzing various indicators of each group of cesarean collection. The results show that the total CNAXE rate was 48.10% and 39.29%, respectively, for 2018 and 2019, respectively, and the cesarean section of the conventional group was 65.75% and 63.64%. By contrasting data of multi-index group and conventional group, hospital B differences were significant ( P < 0.05), and hospital A difference was extremely significant ( P < 0.01). In Cesarean section, obstetric sectors can help maternal treatment strategies by monitoring a series of related indicators for maternal to reduce Cesarean section and improve prognosis.

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Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

Cited by 6 publications

References 21 publications

Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it

Immediate Postpartum Copper IUD: A Comparative Analysis between Profiles of Women who Accept and who Refuse it

Immediate Postpartum Insertion of Copper Intrauterine Device in a Brazilian University Hospital: Expulsion and Continuation Rates

Multi-Indicator Intelligent Monitoring of Clinical Observations to Reduce Cesarean Section

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