Immediate postplacental insertion of a copper intrauterine device: a pilot study to evaluate expulsion rate by mode of delivery.
BACKGROUND
The present study aimed to investigate risk factors for expulsion in immediate postplacental IUD insertion. We specifically sought to determine whether cesarean delivery before or during labor have an impact on IUD expulsion.


METHODS
The study included 160 pregnant women for immediate IUD insertion following vaginal or cesarean delivery. Three groups of patients were recruited: Patients who underwent pre-planned cesarean delivery (group 1, n: 51), patients who underwent cesarean delivery during active labor (group 2, n: 47), patients who delivered vaginally (group 3, n: 62).


RESULTS
The cumulative expulsion rates were similar with a frequency of 8.7, 8.9 and 11.3% respectively in groups 1 to 3 (p > 0.05 in all pairwise comparisons). The rate of patients who had the IUD removed at 12th month was 4,3, 6.7 and 11.3% for groups 1, 2 and 3 respectively (p > 0.05 in all pairwise comparisons). Multiparity increased the risk of cumulative expulsion within 12 months by 2.1 fold (95% 1,03-4,37) in the logistic regression model. Previous vaginal deliveries or IUD use did not have an impact on the expulsion of the IUD. The risk of spontaneous expulsion was similar in patients whose IUD was placed after cesarean in the active and latent phase or after spontaneous vaginal delivery.


CONCLUSIONS
The rates of IUD expulsion are similar in patients who underwent cesarean section before and during labor and who delivered vaginally. Parity was the only factor independently associated with IUD expulsion.
Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. drsucak@yahoo.com.
Ayhan
A
Sucak
Department of Obstetrics and Gynecology, Acıbadem Hospital, Turan Güneş Bulvarı 630.sokak No:6 Or-an, Ankara, Turkey. hsarpozcan@yahoo.com.
Sarp
S
Ozcan
Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. sevkicelen@yahoo.com.
Şevki
Ş
Çelen
Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. turhan_caglar@yahoo.com.
Turhan
T
Çağlar
Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. drgoncagoksu1@gmail.com.
Gonca
G
Göksu
Department of Perinatology, Dr Zekai Tahir Burak Research and Training Hospital, Ankara, Turkey. nuridanisman@gmail.com.
Nuri
N
Danışman
D000328:Adult; D002585:Cesarean Section / Q000379:methods; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007433:Intrauterine Device Expulsion / Q000639:trends*; D007435:Intrauterine Devices, Copper / Q000706:statistics & numerical data*; D010865:Pilot Projects; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D014421:Turkey