الفهرس 
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Abstract
Intrauterine Contraception (IUC) is the most widely used method of reversible fertility regulation in the world. Over 100 million women worldwide use it for contraception.
Immediate post-placental placement of IUCD provides women effective, long-term and reversible contraception that is convenient at a time in their lives when they face considerable demands on their time, unusually high levels of stress and significant disruptions in their usual routines. Previous trials of IUCD placement at the time of cesarean section have demonstrated high levels of device retention and low levels of complications.
World Health organization (WHO) medical eligibility criteria state that risks generally outweigh benefits if postpartum insertion occurs between 48 hours and 4 weeks. However, immediate post-placental IUCD insertion (within 10 min) through the hysterotomy provides a good opportunity to achieve long-term contraception with minimal discomfort to the patient. No studies have reported any increase in the risk of infection or other complications related to this method of IUCD insertion.
We aimed to evaluate efficacy and safety of post placental intrauterine contraceptive device (CU T380) insertion during cesarean section.
This was a prospective cohort study involved 184 full term pregnant women recruited from department of Obstetrics and Gynecology of Kafr El-dawar General Hospital and Menoufia University during the period from 1 January 2020 to 1 January 2022.
All women were subjected to full history taking, clinical assessment and ultrasonographic examination. We inserted IUCD (Cu T380) in all participants during cesarean section. After delivery of placenta, uterine cavity was inspected then the uterus was stabilized by grasping of fundus by left hand. IUCD was held between middle and index finger then inserted through uterine incision and released at the fundus and the strings were passed through the cervix.
Our results showed that:
Regarding continuation of IUCD at different follow-up periods. After one week, IUCD was continued in 161(98.2%) cases, then after 6 weeks there were 156 (96.9%) cases in which IUCD was continued in place. There were 155(94.5%) cases in which IUCD continued in place after 12weeks and after 6 months there were 154(93.9%) cases in which IUCD continued in place.
Regarding complications at different follow-up periods. After one week, IUCD was displaced in 1 case (0.6%) and removed, there was bleeding in 1case (0.6%) which not responded to medical treatment and IUCD removed and 1case of IUCD expulsion.
After 6 weeks there were 2 cases (1.2%) in which IUCD was displaced and removed, 2 cases (1.2%) of bleeding not responding to medical treatment and removed and 1 case (0.6%) of IUCD expulsion.
There was 1 case (0.6%) in which IUCD displaced and removed after 12 weeks.
There was 1case in which IUCD displaced and removed after six months.
Summary
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The continuation rate of IUCD is 154 patients (93.9%) after 6 months.
Total removal rate allover periods of follow up was 6 cases (3.6%) due to displacement and bleeding.
Total expulsion rate was in 2 cases (1.2%) allover periods of follow up.
Total bleeding rate was in 3 cases (1.8%) allover periods of follow up
Total displacement rate was in 5 cases (3%) allover periods of follow up.
There were no cases of perforation and PID reported during the six months of our study.
Conclusion:
The findings of our study confirm previous data that immediate post placental IUD insertion is a feasible contraceptive option with high safety, continuity and convenience.