الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The ideal time of insertion of IUD after cesarean section is a conflicting issue some gynecologists prefer inserting IUDs during cesarean section after removal of the placenta, the success of IUD in reducing unintended pregnancy could be extended if initiated soon postpartum, Intrauterine device placement while still in the delivery room is known as post placental insertion (insertion of the IUD within 10 minutes).
While other gynecologists prefer inserting IUDs after an interval either (42 days) immediately at the end puerprium or six months’ after cesarean section, but the most of them insert IUDs three months after cesarean section. The idea of waiting a three-month interval after cesarean section is to enssure that the scar is completely healed and the uterus returns completely to its pre-pregnancy size, IUD can also inserted soon after abortion or immediately within 10 minutes of delivery of the placenta in vaginal delivery.
Ovulation occurs at a mean of thirty nine days postpartum in non-lactating women, and can occur as early as twenty five days, putting postpartum women at risk of unintended and short-interval pregnancy.
The immediate postpartum period has a lot of potential benefits for implants or IUD insertion because Women are known not to be pregnant and many women are motivated to avoid short-interval pregnancy.
The Centers for Disease Control and Prevention’s 2010 U.S. Medical Eligibility Criteria for Contraceptive Use (MEC)* about the safety of postpartum contraceptive use. Immediate postpartum initiation of IUDs is classified as Category 1 (no restriction on it’s use) or Category 2 (the advantages of it’s use can outweigh the theoretical or proven risks).
Expulsion rates for immediate postpartum IUD placement are more higher tthan that inserted after interval or aftermiscarriage. Women should be told about the increased risk of expulsion and should be learned about the symptoms and signs of expulsion.
Inspite of the higher expulsion rate of immediate postpartum IUD insertion over interval insertion, evidence from clinical trials and from cost-benefit analyses strongly suggest the superiority of immediate insertion in reducing unintended pregnancy, especially for those at greatest risk of not having recommended postpartum follow-up.
The study aimed to assess the site, position and complications of IUD inserted during caesarean section.
This randomized controlled study included 120 women who attended to El-Shatby university hospital for elective cesarean section and desiring immediate contraception.
The main results of the study revealed that:
In group 1, Mean Age (year) was 28.17 ± 4.69. Mean Weight (Kg) was 73.02 ± 7.04. Mean Height (meter) was 1.62 ± 0.05. Mean BMI (kg/m²) was 27.76 ± 3.34.
In group 2, Mean Age (year) was 27.45 ± 4.26. Mean Weight (Kg) was 72.62 ± 6.89. Mean Height (meter) was 1.62 ± 0.04. Mean BMI (kg/m²) was 27.59 ± 3.02.
In group 1, 39 (65%) patients had family planning counseling. 21 (35%) patients did not. 41 (68.33%) patients had Previous use of IUD. 19 (31.67%) patients did not have Previous use of IUD.
In group 1, Mean SBP, mmHg was 110.6 ± 4.93. Mean DBP, mmHg was 75.63 ± 3.57. Mean HR, Beats Per Minute was 80.7 ± 3.63. Mean Respiratory rate / min was 15.1 ± 0.63. Mean Temperature was 36.85 ± 0.17.
In group 2, Mean SBP, mmHg was 110.77 ± 5.18. Mean DBP, mmHg was 75.5 ± 3.47. Mean HR, Beats Per Minute was 81.43 ± 3.34. Mean Respiratory rate / min was 15.1 ± 0.6. Mean Temperature was 36.81 ± 0.15.
There was no significant difference between groups.
In group 2, 25 (41.67%) patients had family planning counseling. 35 (58.3%) patients did not. 40 (66.67%) patients had Previous use of IUD. 20 (33.3%) patients did not have Previous use of IUD.
There was no significant difference between groups except for family planning counseling.
In group 1, Mean Hemoglobin g/dl was 11.2 ± 12.3. Mean WBCs count was 10 ± 4. Mean platelet count *1000/microliter was 250 ± 22.93. Mean Ptt (sec) was 30.23 ± 2.45. Mean INR was 1 ± 0.07. Mean Random blood glucose mg/dL was 91.33 ± 6.03.
In in group 2, Mean Hemoglobin g/dl was 12.3 ± 1.45. Mean WBCs count was 7 ± 4.25. Mean platelet count *1000/microliter was 170 ± 20.08. Mean Ptt (sec) was 30.05 ± 2.02. Mean INR was 1.01 ± 0.08. Mean Random blood glucose mg/dL was 90.66 ± 6.61.
There was no significant difference between groups.
In group 1, Mean Parity was 2.25 ± 0.82. Mean Gravidity was 3.27 ± 1.02. Mean GA was 38.37 ± 1.12. Mean previous CS incidence was 0.78 ± 0.66.
In group 2, Mean Parity was 2.47 ± 1.13. Mean Gravidity was 2.75 ± 1.23. Mean GA was 38.55 ± 1.16. Mean previous CS incidence was 0.75 ± 0.64.There was no significant difference between groups
All patient in both group had normal IUD in place by 2D US.