Aim:
To determine the difference between the postplacental insertion of intrauterine device (IUD) in women with vaginal and cesarean delivery.
Methods:
This study included 142 women who gave birth between 38 to 42 weeks of pregnancy. Group 1 had elective cesarean delivery (n=79) and, group 2 had vaginal delivery (n=63). IUD was placed in the uterine fundus within 10 minutes of placental delivery. The subjects were examined at the 1st week, 6th week, 6th month, 12th month postpartum. Age, gravida, parity, type of delivery, number of previous vaginal deliveries, and previous IUD use were evaluated.
Results:
Parity and maternal age were similar between the groups. The number of patients giving at least one vaginal delivery in group 1 was higher than in group 2 (p<0.01). The rate of IUD expulsion was similar between the groups. IUD expulsion occurred within the first six weeks in more than 50% of patients in both groups. Cumulative IUD removal rate was found to be 7.2%. Removal rates were similar between the groups (p>0.05). There was a 2.1-fold increase (95% confidence interval;1.03-4.37) in the risk of cumulative withdrawal one year after insertion in multiparous women.
Conclusion:
Postpartum IUD insertion may be promising as a safe and effective method of family planning. In spite of the fact that the expulsion rates were higher than in previous studies, the experience of the practitioners probably increased further. Parity is the most important risk factor for IUD expulsion, rather than the way of birth.
Keywords: Intrauterine device,postpartum insersion,expulsion rate