Evaluation of Immediate Post-placental Insertion of the Copper Intrauterine Contraceptive Device during Caesarean Delivery

Background: The second most popular type of contraception is an intrauterine contraceptive device (IUCD). Immediate post-placental placement of IUCD provides women with immediate, safe, effective, long-acting reversible contraception that prevents unintended pregnancies.
Objective: The aim of the current work was to evaluate efficacy, safety, and complications (displacement, expulsion, perforation, and infection) of immediate post placental insertion of copper T380 IUCD during cesarean section.
Patients and methods: This prospective study included a total of 164 full term pregnant women delivered through cesarean section, attending at Department of Obstetrics and Gynecology, Menoufia University Hospital and Department of Obstetrics and Gynecology, Kafr El-dawar General Hospital. Post-placental copper T380 IUCD was offered after admission and inserted during cesarean section. Rates of IUCD displacement, expulsion, removal, uterine perforation, pregnancy and infection (endometritis/PID) were estimated at 1 week, 4 weeks, 3 months and 6 months after discharge. The absence of all these complications was considered a satisfactory outcome.
Results:  Mean age among study population was 28.45± 5.14 years. Rates of displacement, expulsion and satisfactory outcome at the fourth week post-insertion were 2.5%, 0.6 % and 96.9% respectively. Cumulative rates of displacement and expulsion at the end of 6-months follow-up were 4.3% and 0.6% respectively. No cases complicated by perforation, infection (endometritis/ PID) or pregnancy on top of post placental IUCD. Follow-up rate at the end of 6-months was 94.5%. Continuation rate with intrauterine contraception at the end of 6-months follow-up was 93.9%. Cumulative rate of intrauterine device removal was 6.1%. Conclusion: It could be concluded that immediate post placental IUCD insertion is a suitable option with high satisfactory outcome, contraceptive efficacy, safety, and convenience. Complications (displacement, expulsion, perforation and infection) are very low.