title: Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section.
abstract: BACKGROUND
  An intrauterine device (IUD) is an effective reversible form of contraception. We determined the efficacy and safety of immediate postplacental IUD insertion during cesarean section.
  
  
  METHODS
  Two hundred forty-five women with term pregnancies delivering by cesarean section between September 2006 and December 2007 were included in the study. A copper IUD (TCu 380A) was inserted using a ring forceps within 10 min of removing the placenta. The participants were examined before hospital discharge and at 6 weeks, 6 months and 12 months postpartum.
  
  
  RESULTS
  None of the patients were lost to follow-up. There was one case of an unplanned pregnancy (0.4%). There were no serious complications associated with immediate IUD insertion during cesarean section. The cumulative rates of expulsion, removal for bleeding/pain and other medical reasons were 17.6, 8.2 and 2.4 per 100 women per year, respectively. The continuation rates were 81.6% and 62% at 6 and 12 months, respectively.
  
  
  CONCLUSIONS
  Immediate postplacental IUD insertion during cesarean section provides adequate protection against pregnancy. However, greater than one fourth of the participants discontinued IUD use due to spontaneous expulsion or other medical reasons.
authors.affiliation: Zekai Tahir Burak Women's Health Training and Education Hospital, 06230, Ankara, Turkey. sevkicelen@yahoo.com
authors.forename: Şevki
authors.initials: Ş
authors.lastname: Çelen
authors.forename: Ayhan
authors.initials: A
authors.lastname: Sucak
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Yıldız
authors.forename: Nuri
authors.initials: N
authors.lastname: Danışman
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007435:Intrauterine Devices, Copper; D011247:Pregnancy; D055815:Young Adult