Puerperal and menstrual bleeding patterns with different types of contraceptive device fitted during elective cesarean delivery.
OBJECTIVE
To evaluate the impact of a copper-containing intrauterine contraceptive device (IUCD) and the levonorgestrel-releasing intrauterine system (IUS) on puerperal and menstrual bleeding when fitted intraoperatively during scheduled elective cesarean.


METHODS
Participants were allocated to 3 groups: cesarean with no device inserted; IUCD inserted during cesarean; and IUS inserted during cesarean.


RESULTS
There was significantly shorter and lighter puerperium in the IUS group (20.2 ± 7.7 days and 3.1 ± 1.6 pads/day) than in the IUCD (33.4 ± 9.5 days and 4.9 ± 2.4 pads/day) and the control (27.0 ± 11.4 days and 4.9 ± 2.3 pads/day) groups (P<0.012 and P<0.0001, respectively). At the end of puerperium, mean duration of amenorrhea was significantly longer in the IUS group than in the IUCD and control groups (P<0.0001). Menstrual periods were longer and heavier in the IUCD group than in the control group but the difference was not significant (P>0.07). In the IUS group, menstrual periods were significantly shorter and lighter than in the other groups (P<0.0001).


CONCLUSIONS
Intrauterine system fitting at the time of elective cesarean is associated with significant reductions in the duration and amount of puerperal blood loss, as well as a high incidence of amenorrhea and lighter periods thereafter.
Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt. mervatsheikhelarab@yahoo.com
Mervat S E
MS
Elsedeek
D000328:Adult; D002585:Cesarean Section; D004534:Egypt; D017558:Elective Surgical Procedures; D005260:Female; D006761:Hospitals; D006801:Humans; D007434:Intrauterine Devices; D007435:Intrauterine Devices, Copper; D008595:Menorrhagia / Q000517:prevention & control*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D016896:Treatment Outcome