Intrauterine contraceptive device insertion with suture fixation at cesarean section.

ABSTRACT

PIP 150 women had an IUD inserted at cesarean section in a hospital in Beijing, China, from April 1981-82. A new suture fixation method was used in which the catgut was sutured to fix the ring on the posterior uterine wall to prevent premature expulsion. Of the 150 cases 148 were primigravida and 2 multipara, ages 23-33. Fetal membrane rupture time was 1) 31 over 6 hours, 2) 7 over 24 hours, 3) 2 over 48 hours predelivery. After IUD insertion oxytocin was routinely given 3 days and the patients were examined periodically 42 days, 3 months, 6 months, 1 year, and 2 years after insertion. At 42 days, postinsertion, there was only 1 partial expulsion among the 150, and 4 complete expulsions among 130 (3%), all in women with dilated external os. After 3 months infection rate was 0.77%, 3 became pregnant and accepted induced abortion. There were no perforations or painful uterine contractions. Total incidence rate of side effects was 6.92%, in 85.39% lochia stopped within 42 days and in 14.62% it continued beyond 42 days. It was found in this study that the larger size IUD caused no pregnancy in the 3-month period postpartum, especially for those not nursing, with early ovulation, or at a high fertile age.^ieng