Hang-up Technique versus Non-fixation Technique for Immediate Post-placental IUD Insertion during Cesarean Section: A Randomized Controlled Trial

Abstract

Background: Postpartum intrauterine device (IUD) insertion provides safe and extremely effective contraception, while women are receiving medical treatment.

Objective: To evaluate the expulsion rate of IUD implantation during caesarean section (CS) using the hang-up and non-fixation techniques.

Patients and Methods: This is a randomized controlled trial from the Women's Health Hospital, Assiut University, Egypt. Eligible women  for inclusion were the pregnant women after age of viability (28 weeks) who were undergoing elective or emergency cesarean section (n  = 118). Participants were divided into two groups; 59 participants in each study group. IUD was inserted using the hang-up technique in  one group and using non-fixation technique in the other group.

Results: No cases of IUD expulsion were reported in the 1st group; however, the expulsion rate was high in the nonfixation group (0% Vs  12.5%, p = 0.013). Moreover, hang up technique showed higher continuation rate after 6 months of delivery than non-fixation technique  (96.4 %, Vs 78.8 % P = 0.003). No significant differences were detected between both study groups regarding postpartum endometritis,  heavy menstrual bleeding, pelvic infection, and dysmenorrhea.

Conclusion: The hang-up technique resulted in better IUD fixation with  higher continuation rate and less expulsion rate than on –fixation technique. IUD fixation during cesarean section was safe easy and  rapid learning curve.