Five‐year follow‐up of two types of contraceptive device fitted during elective cesarean delivery

Abstract

Although misalignment of an IUCD or the IUS is fairly common after intraoperative insertion, the contraceptive performance and menstrual pattern are not affected. Therefore, there is no need to remove or replace a misaligned IUCD or IUS.

Intrauterine Device Expulsion After Postpartum Placement

“…7,18,19 Twenty-two studies included only CuT380A IUDs, 8,16–18,20–37 13 included only LNG-IUS, 19,38–49 and nine included a mix of the two 7,9,10,14,50–54 ; the remaining four studies included CuT200 55–57 or Cu7 IUDs. 58 Twenty-eight studied women with IUDs placed only in the immediate postpartum period, 9,10,14,17,18,21,23,24,26–30,32–37,40–43,52–54,57,58 four studied only early postpartum placements, 44,47,55,56 and the remaining 16 studied more than one placement period. 7,8,16,19,20,22,25,31,38,39,45,46,48–50,51 Similar numbers of studies evaluated vaginal and cesarean deliveries, with 14 including only vaginal deliveries, 14,16,19,20,22,31,34,39,42,44,45,48,53,5816 including only cesarean deliveries, 7,8,17,18,27–30,35,37,38,40,41,43,46,54 16 including both delivery methods, 9,10,21,…”

“…58 Twenty-eight studied women with IUDs placed only in the immediate postpartum period, 9,10,14,17,18,21,23,24,26–30,32–37,40–43,52–54,57,58 four studied only early postpartum placements, 44,47,55,56 and the remaining 16 studied more than one placement period. 7,8,16,19,20,22,25,31,38,39,45,46,48–50,51 Similar numbers of studies evaluated vaginal and cesarean deliveries, with 14 including only vaginal deliveries, 14,16,19,20,22,31,34,39,42,44,45,48,53,5816 including only cesarean deliveries, 7,8,17,18,27–30,35,37,38,40,41,43,46,54 16 including both delivery methods, 9,10,21,23–26,32,33,36,47,49,50,51,52,57 and two not reporting delivery method. 55,56 Sample sizes ranged from 7–2,733 women; follow-up duration ranged from 4 weeks–5 years, and follow-up rates ranged from 29–100%.…”

Reversible, Long - Action Reproductive Control with Frameless IUD for Intracesarean Insertion

“…Both copper IUDs and also levonorgestrelreleasing intrauterine system (LNG-IUS) can be used as the hormone released in the uterine cavity does not affect breast feeding [3]. According to a study conducted in Egypt, the levonorgestrel intrauterine system fitted at the time of elective cesarean was associated with significant reductions in the duration and amount of puerperal blood loss, as well as a high incidence of amenorrhea and lighter periods there after [4]. This may be important to help women recover more quickly from anemia after childbirth and avoid the break through bleeding and spotting episodes that often lead to removal of the LNG-IUS.…”

“…The devices were displaced in almost half of the women. 4 Displacement will likely cause discrepancy and embedment during involution of the uterus, particularly during prolonged lactation as hyper involution in these women is not uncommon [10].…”