Efficacy and Safety of Ultrasound Guided versus Blind Technique for Office Insertion of Intrauterine Contraceptive Device in Women with Previous Cesarean Section; A Randomized Controlled Clinical Trial

Document Type : Original Article

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Obstetrics and gynecology faculty of medicine ain shams university Cairo Egypt

Abstract

Background: Intrauterine devices (IUD) are a highly successful type of contraception, if not the most effective, with normal use-related failure rates of 0.2-0.8 percent. Difficulties with IUD application, failure, and complications can reduce the use of this successful technique.
Objective: Comparison between ultrasound guided and blind IUD insertion technique as regards proper fundal location, incidence of complications, time consumption and patient satisfaction in women with previous cesarean section.
Methods: The randomized controlled comparative clinical was conducted of 100 women attended family planning clinic seeking contraceptive method. All eligible participants were randomly distributed into two equal groups. For both groups, Copper TCu-380A (Pregna®, DKT, Egypt) was inserted with withdrawal insertion technique blindly in group A and ultrasound guided in group B.
Results: The time needed for the procedure was statistically significant shorter, degree of pain during IUD insertion was lower and patient satisfaction was higher with ultrasound guided insertion technique compared with blinded one. On the other hand, there were no statistically significant differences between study groups as regard proper fundal device placement, degree of difficulty during insertion, post insertion infection, bleeding during and post insertion and rate of complications as perforation and expulsion.
Conclusion: Ultrasound guided IUD insertion is more effective than blind technique with lesser pain score and better patient satisfaction.

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