title: A randomised clinical trial to assess satisfaction with the levonorgestrel- releasing intrauterine system inserted at caesarean section compared to postpartum placement.
abstract: BACKGROUND
  Insertion of levonorgestrel-releasing intrauterine system (LNG-IUS) at caesarean section (CS) provides contraception prior to resumption of ovulation or sexual activity. Patient satisfaction with insertion at CS has not previously been studied.
  
  
  OBJECTIVE
  The aim of this study was to compare patient satisfaction with LNG-IUS inserted at the time of lower uterine segment CS to six weeks postpartum.
  
  
  METHODS
  Open-label randomised controlled trial. Women booked for elective CS were randomised to LNG-IUS insertion either at the time of CS (study group) or at six weeks postpartum (control group). The primary outcome measure was patient satisfaction. Outcomes were measured at six weeks, three months and six months postpartum.
  
  
  RESULTS
  Forty-eight women were randomised into two treatment groups. Twenty-five women were randomised to have LNG-IUS inserted at the time of CS, 23 of whom had the planned intervention and two had the LNG-IUS inserted postpartum. Twenty-three women were randomised to the control group, four of whom withdrew prior to treatment. The 44 remaining women contributed to data analysis. Patient satisfaction was high and similar in both groups. At six months postpartum, 90.5% of the study group were very satisfied or somewhat satisfied compared with 88.2% of the control group.
  
  
  CONCLUSIONS
  Patient satisfaction is high with LNG-IUS insertion at CS and not different to that with delayed insertion. LNG-IUS insertion may be an option for women who find postpartum contraception difficult to access.
authors.affiliation: Department of Obstetrics and Gynaecology, Mackay Base Hospital, Queensland, Australia.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Braniff
authors.affiliation: Department of Obstetrics and Gynaecology, Mackay Base Hospital, Queensland, Australia.
authors.forename: Edmund
authors.initials: E
authors.lastname: Gomez
authors.affiliation: Department of Public Health, James Cook University, Townsville, Queensland, Australia.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Muller
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002585:Cesarean Section; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007436:Intrauterine Devices, Medicated / Q000009:adverse effects; D016912:Levonorgestrel / Q000008:administration & dosage*; D017060:Patient Satisfaction; D049590:Postpartum Period; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel
keywords: caesarean section; intrauterine devices, medicated; levonorgestrel-releasing intrauterine system; patient satisfaction; postpartum period