Background: Intrauterine devices (IUDs) are a popular contraceptive option for women worldwide. While traditionally inserted postpartum, there is growing interest in intraoperative placement during cesarean delivery as a convenient and effective strategy. This study aimed to evaluate the efficacy and safety of non-hormonal copper IUD insertion during cesarean sections and compare outcomes with postpartum insertion.
Methods: This prospective case-control study enrolled women aged 18-45 years undergoing cesarean section at Benha University's Obstetrics & Gynecology department from June 2021 to June 2023. Participants were divided into two groups: Group 1 (intrapartum) received IUD insertion during cesarean section, and Group 2 (postpartum) received insertion six weeks after discharge.
Results: Of the 130 women assessed, 104 met inclusion criteria and were included in the study (Group 1: n=50, Group 2: n=54). There were no failed insertions in either group. Hemoglobin levels were significantly lower in Group 1 compared to Group 2 after one week (9.3 vs. 10 g/dl, P=0.000) and six weeks (9.75 vs. 10.35 g/dl, P=0.0001). At six weeks, bleeding and IUD removal rates were 4% in Group 1 and 7.41% in Group 2 (P=0.457). Rates of expulsion were 2% in Group 1 and 3.7% in Group 2 (P=0.604). Displacement and removal rates were similar between groups (4% vs. 3.7%, P=0.937).
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