title: Comparison between the traditional non-guided and a novel ultrasound-guided technique for office fitting of intrauterine contraceptive devices.
abstract: OBJECTIVE
  To investigate a novel method for in-office fitting of intrauterine contraceptive devices (IUCDs) by comparing it to the traditional non-guided technique.
  
  
  METHODS
  A prospective cohort study comparing the application of intrauterine contraceptives was conducted between January 1, 2013 and January 31, 2015 at a university contraception clinic, in Alexandria, Egypt. Patients aged 20-45years who were parous, had previously undergone vaginal or abdominal deliveries, and were requesting device insertion were included. Patients were randomly assigned to have devices fitted using the non-guided approach, with vaginal ultrasonography to plan and confirm device placement, or by the abdominal ultrasonography-guided technique. The primary outcomes were successful IUCD insertion and ideal device position 1week after insertion. Participants, counselors, and data analysts were masked to treatment assignments.
  
  
  RESULTS
  Analyses included 40 patients in each treatment arm. Successful fitting was achieved in 32 (80%) patients in the non-guided arm and 39 (98%) patients in the ultrasonography-guided arm (P=0.04). Ideal placement was achieved in 38 (95%) patients in the ultrasonography-guided arm compared with 27 (68%) patients in the non-guided arm (P=0.02).
  
  
  CONCLUSIONS
  Ultrasonography-guided IUCD insertion demonstrated improved success and fitting accuracy in comparison with a traditional, non-guided approach. ANZCTR trial ID: ACTRN12615000526572.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; Shatby Maternity University Hospital, Alexandria University, Alexandria, Egypt. Electronic address: mervatsheikhelarab@yahoo.com.
authors.forename: Mervat S
authors.initials: MS
authors.lastname: Elsedeek
mesh_terms: D000328:Adult; D003267:Contraception / Q000379:methods*; D004534:Egypt; D005260:Female; D020073:Gravidity; D006801:Humans; D007436:Intrauterine Devices, Medicated; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography
keywords: Intrauterine contraceptive devices; Ultrasound-guided technique