title: Intrauterine Device Placement During Cesarean Delivery and Continued Use 6 Months Postpartum: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare intrauterine device (IUD) use at 6 months postpartum among women who underwent intracesarean delivery (during cesarean delivery) IUD placement compared with women who planned for interval IUD placement 6 or more weeks postpartum.
  
  
  METHODS
  In this nonblinded randomized trial, women who were undergoing a cesarean delivery and desired an IUD were randomized to intracesarean delivery or interval IUD placement. The primary outcome was IUD use at 6 months postpartum. A sample size of 112 (56 in each group) was planned to detect a 15% difference in IUD use at 6 months postpartum between groups.
  
  
  RESULTS
  From March 2012 to June 2014, 172 women were screened and 112 women were randomized into the trial. Baseline characteristics were similar between groups. Data regarding IUD use at 6 months postpartum were available for 98 women, 48 and 50 women in the intracesarean delivery and interval groups, respectively. A larger proportion of the women in the intracesarean delivery group were using an IUD at 6 months postpartum (40/48 [83%]) compared with those in the interval group (32/50 [64%], relative risk 1.3, 95% confidence interval 1.02-1.66). Among the 56 women randomized to interval IUD insertion, 22 (39%) of them never received an IUD; 14 (25%) never returned for IUD placement, five (9%) women declined an IUD, and three (5%) had a failed IUD placement.
  
  
  CONCLUSIONS
  Intrauterine device placement at the time of cesarean delivery leads to a higher proportion of IUD use at 6 months postpartum when compared with interval IUD placement.
  
  
  METHODS
  I.
authors.affiliation: Division of Family Planning and Global Health, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York; and the Division of Family Planning, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Erika E
authors.initials: EE
authors.lastname: Levi
authors.forename: Gretchen S
authors.initials: GS
authors.lastname: Stuart
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Zerden
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Garrett
authors.forename: Amy G
authors.initials: AG
authors.lastname: Bryant
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult