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Safety profile of immediate post-partum intrauterine device insertion during caesarean delivery – a clinical trial with three years of follow up: Utility of Immediate Post Placental Insertion of Intrauterine Device During Cesarean Delivery
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Background: Many countries recommend the use of long-acting reversible contraceptive intrauterine device immediately after cesarean delivery. The cesarean delivery rate in Iraqi public hospitals is 32.2% and may reach 85.8% in private hospitals. Immediate post-partum intrauterine device insertion at cesarean is rarely done in Iraq.

Objectives: To assess the safety and practicality of immediate post-partum intrauterine device insertion during cesarean delivery for family planning and pregnancy spacing in Iraqi women.

Subjects and Methods: A single arm clinical trial included 150 eligible women who attended Al-‎Elwiyah Maternity Teaching Hospital or Al Hayat Rahibat Hospital for term delivery. A copper intrauterine device was placed in the uterine cavity immediately after delivery of the placenta during cesarean delivery. The intrauterine device was fixed in place at the fundus using an absorbable suture. Patients were followed up at six weeks, then annually for three years.

Results:  Expulsion of the intrauterine device was not reported by any of the participants. The most-reported complaints in the first twelve months of intrauterine device placement were abdominal pain, abnormal vaginal discharge, and ‎heavy menstrual blood loss, however, none were statically significant (P= 0.256). After the first year, there was a significant reduction in the ‎frequency of complaints (P= 0.002).  Only 7.33% (95% CI: 6.92–7.75%) of the patient requested intrauterine device removal within the three years. The main reason was to plan a new pregnancy followed by recurrent infection associated with uncontrolled diabetes ‎mellitus. Diabetes was ‎a significant predictor for immediate post-partum intrauterine device removal, P= 0.049.

Conclusion: The intrauterine device placement during cesarean delivery with suture fixation is a safe procedure with a zero-expulsion rate and is an effective reversible long-term contraceptive method.

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Publication Date
Tue Dec 27 2022
Journal Name
Chemical Papers
Synthesis, characterization, and application of external gelation of sodium alginate nanoparticles in molecular imprinting for separation and drug delivery of tenoxicam
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Mon Sep 15 2025
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Clinicopathological analysis of oral squamous cell carcinoma in Iraq During period (2001-2013)
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Fri Dec 01 2023
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Aip Conference Proceedings
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Fri Mar 01 2024
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Quantitative Analysis of Isometric Ankle Torque and Muscle Activity during Dorsiflexion and Plantarflexion
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Mon Dec 30 2024
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Publication Date
Thu Sep 15 2022
Journal Name
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Coil migration during pressure-cooker technique for cerebral AVM
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Publication Date
Sun Sep 11 2022
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Non-Productive Time Reduction during Oil Wells Drilling Operations
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Fri May 20 2022
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Publication Date
Fri Sep 15 2023
Journal Name
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Ruthlessness against Women during Wars in Danai Gurira's Eclipsed
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