Visibility of Strings After Postplacental Intracesarean Insertion of CuT380A and Cu375 Intrauterine Contraceptive Device: A Randomized Comparative Study

Agarwal, Krishna; Dewan, Rupali; Mittal, Pratima; Aggarwal, Abha

doi:10.1007/s13224-017-0965-8

Cited by 6 publications

(9 citation statements)

References 10 publications

(33 reference statements)

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“…After postplacental insertion at the time of cesarean delivery, IUD strings may be more likely to be visualized for LNG-IUDs than for CuT380A IUDs [31], likely because of the LNG-IUD's longer strings. In addition, strings may descend into the vagina with further involution of the postpartum uterus and thus may become visible over time after postplacental insertion [74,76,77]. One prospective cohort study of 348 women who received a CuT380A IUD after vaginal or cesarean delivery found an increase in IUD string visibility over time, with 90% and 32% of strings visible at 6 weeks after vaginal and cesarean deliveries, respectively, compared with 98% and 72% at 12 months [74].…”

Section: Missing Stringsmentioning

confidence: 99%

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Whitaker

Chen

2018

Contraception

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Postplacental intrauterine device (IUD) placement, defined as IUD placement within 10 min after delivery of the placenta, is an appealing strategy for increasing access to postpartum IUDs because it does not require a separate postpartum visit. These guidelines present an evidence-based assessment of postplacental IUD placement after vaginal and cesarean delivery. Postplacental IUD insertion is safe and does not have higher risks of complications than interval insertion. Most studies find that the risk of IUD expulsion is higher after postplacental insertion than after interval insertion for both vaginal and cesarean deliveries. Most studies find higher rates of expulsion after vaginal delivery than after cesarean delivery. However, expulsion rates vary widely across studies, without clear evidence about the factors that may influence expulsion. In settings where replacement of expelled IUDs is available, patient populations with low rates of return for the postpartum visit are most likely to benefit from provision of postplacental IUD placement with appropriate counseling about risks and benefits.

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Section: Missing Stringsmentioning

confidence: 99%

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Whitaker

Chen

2018

Contraception

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“…Also, the removal of IUCD with visible strings is easy. 7 In this study, authors observed that patients were more apprehensive of the strings visible at introitus but not about non-visibility.…”

Section: Discussionmentioning

confidence: 60%

“…Visibility of strings at 6-weeks follow up visit was 62% for CuT380A and 92% for Multiload Cu375 in a study by Kavita et al 7 Lower expulsion rate of 3.33% at 6 weeks follow up was observed in this study as shown in chart 3 due to our technique of insertion, similar to 4.49 % in a study by Swathi et al and 4% in CuT380A and 2% in multiload Cu375 in a study by Kavita et al 7,11 Previous studies indicate that expulsion rates after intra-caesarean IUCD insertion are much lower probably due to correct placement at the fundus. 7 Spontaneous expulsion rate is 0.84% in intra-caesarean insertion compared to vaginal insertion (1.84%) in a study by Gupta P et al 13 Counseling of the women and confirmation of IUCD in uterine cavity by ultrasound are important to reassure and encourage women to continue PPIUCD. 5 In all cases irrespective of strings visibility, ultrasound was required to confirm intrauterine position and relation to the fundus because contraceptive efficacy is better when it is in normal position and less than 1cm away from the fundal endometrium.…”

Section: Discussionmentioning

confidence: 85%

“…Pelvic infection was diagnosed if women had cervical, adnexal, or uterine tenderness or purulent discharge with or without fever. 7 postpartum IUCD insertions in a study by Poornima et al 13 Pain abdomen was noted in only one case which could be treated with simple analgesics. This shows that significant abdominal pain is not seen in intra-caesarean IUCD insertion.…”

Section: Discussionmentioning

confidence: 96%

“…Insertion during caesarean section has a lower expulsion rate than insertion during the postpartum (first 48 hours) period due to the fact that it is easier to reliably reach the uterine fundus during intracaesarean insertion and insertion is under vision thus obviating the fear of perforation of uterus. 4,7 IUCD placement in the immediate postpartum period increases overall IUCD use. 2 IUCDs have a rapid onset of action after insertion with a rapid return to fertility after discontinuation.…”

mentioning

confidence: 99%

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A prospective interventional study of intra-caesarean copper intrauterine contraceptive devices insertion in a teaching hospital in a rural medical college in Telangana, India

Gillella¹,

Kothapally²,

Bhashyakarla³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONProviding quality contraceptive services to women is essential for achieving maternal and child health. Unwanted and untimed pregnancies result in adverse outcomes for mother and child. Short birth intervals are associated with adverse perinatal and maternal outcomes. 27% of births occur within 24 months after a previous birth and 34% occur between 24 and 35 months. 1More than 50% of non-breastfeeding women ovulate and more than 50% are sexually active by 6 weeks postpartum. 2 In India, 65% of women have an unmet need for family planning in the first year postpartum. 3 ABSTRACT Background: Providing quality contraceptive services to women is essential for achieving maternal and child health. Objective of this study was to evaluate the efficacy of intra-caesarean insertion of copper IUCDs as postpartum contraception. To study the side effects of intra caesarean copper device. To study the continuation rates of intracaesarean copper IUCDs. To study the acceptability of intra-caesarean copper IUCD as immediate postpartum contraceptive. Methods: The prospective study was undertaken at Bhaskar medical college and general hospital, Yenkepally, Moinabad, Telangana, between January 2016 and March 2018 after ethical committee clearance. About 60 pregnant women were enrolled into the study after an informed written consent regarding the procedure, benefits and complications and the need for follow up for at least one year. Copper T 380A/multiload copper 375 was inserted into the uterine cavity after delivery of the placenta and membranes during caesarean section. Patients were followed up at 6 weeks, 6 months and one-year intervals for any complaints, visibility of threads and for ultrasound examination for position of copper IUCDs in the uterus. Data analysis was done using Microsoft excel 2016. Results: Nearly 48.33% continued intra-caesarean copper IUCDs for more than 1 year. 70% did not have any complaints. 86.67% came for more than one follow-up visit. 47% had copper IUD threads visible by one year. No case of perforation either during insertion or during continuation was noted. None conceived with copper IUCD in situ. Removal of copper IUCD was also easy and none required hysteroscopic removal. Conclusions: Intra-caesarean copper IUCD insertion is a safe and effective long acting reversible contraceptive method in the postpartum period.

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Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis

Averbach

Ermias

Jeng

et al. 2020

American Journal of Obstetrics and Gynecology

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Visibility of Strings After Postplacental Intracesarean Insertion of CuT380A and Cu375 Intrauterine Contraceptive Device: A Randomized Comparative Study

Cited by 6 publications

References 10 publications

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

A prospective interventional study of intra-caesarean copper intrauterine contraceptive devices insertion in a teaching hospital in a rural medical college in Telangana, India

Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis

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