Intra-cesarean Post Placental Introducer Withdrawal IUD Insertion Technique
Condition: Intrauterine Contraceptive Device Complication
Study type: Interventional

Summary: 
      This is a prospective randomized controlled study that was conducted to compare between the
      conventional (manual) technique of post placental IUD insertion and a new technique
      (intra-cesarean post placental introducer withdrawal IUD insertion technique) for IUD
      insertion during cesarean section regarding side effects and complications.
    

Detailed description: 
      Complete history taking and clinical examination were obtained from all cases. Lower segment
      cesarean section though Pfannenstiel incision was performed. Copper T380 IUDs were inserted
      to all participants during cesarean section after delivery of the placenta using the
      following techniques:

      Group A (control group): (n = 420) First, the investigators Performed time out and verify
      that there were no contraindications to IUD placement:, Second, after package opening the
      investigators Removed the IUD from the introducer and trimmed IUD threads to 12 cm, Third,
      the investigators Grasped the IUD firmly along the stem of the device, Fourth the
      investigators Stabilized the uterus using the non-dominant hand or with the aid of an
      assistant and advanced the IUD through the hysterotomy to the fundus, Fifth, the
      investigators Removed hand and directed the IUD threads into the cervix and finally the
      investigators Closed the uterine incision, took care not to incorporate the IUD strings.

      Group B (study group): (n = 420) First the investigators Performed time out and verified that
      there were no contraindications to IUD placement, Second, after package opening the
      investigators Removed IUD from the introducer and trimmed the IUD threads to 12 cm and also
      trimmed the introducer to 12 cm, Third, the investigators Loaded the IUD again inside the
      introducer (through the trimmed end) and kept the arms of the IUD unfolded, Forth, the
      investigators removed the shoulders of the introducer, Fifth, the investigators held the
      uterus and stabilized it by the non-dominant hand and guided the introducer containing the
      IUD strings first through the cervix then the investigators advanced the introducer with the
      IUD arms unfolded to the fundus and kept the IUD their by pressing on the fundus, then the
      investigators pushed the introducer gently through the cervix to the vagina, Finally, the
      investigators Closed the uterine incision, took care not to incorporate the introducer or the
      threads and then the investigators removed the introducer gently manually from the vagina
      after closure of the skin and ceiling of the wound.
    

Intervention name(s): IUD insertion during cesarean section
Intervention type(s): Procedure
Intervention description(s): placement of IUD during cesarean section after placental delivery
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Prevention