Insertion of intrauterine devices after cesarean section: a systematic review update

International Journal of Women's Health

关键词: post-placental IUD;    caesarean section;    missing IUD threads;    IUD expulsion;    long-acting reversible contraception;   

DOI  :  

来源: DOAJ

【 摘 要 】

Norman D Goldstuck,1 Petrus S Steyn21Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Western Cape, 2Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South AfricaBackground: Women who undergo a cesarean section (CS) are in a unique position to receive the intrauterine contraceptive device (IUD). They may also want to use the IUD as a long-acting reversible contraceptive method provided the IUD is safe and effective in the presence of a CS scar. Search strategy: We researched and reviewed the MEDLINE, POPLINE, Google Scholar, and ClinicalTrials.gov databases from January 1968 to June 2015. Selection criteria: Eligible studies reported event rates or practical problems relating to IUD usage in post-placental or interval insertion (>90 days) after CS. Studies with ≥20 subjects were included. Data collection and analysis: Analysis of eligible data collected from the search followed the PRISMA guidelines. Main results: Twelve eligible studies of post-placental IUD insertion after CS included four randomized controlled trials of post-placental versus delayed insertion. Women randomized to delayed insertion were less likely to receive a device. Six studies examined the problem of missing IUD threads at follow-up with only 30%–60% presence of strings observed. Conclusion: The IUD is a long-acting reversible contraceptive method that is suitable for use in all women undergoing CS. The problems of device expulsion, missing threads at follow-up, and the tendency of increased puerperal bleeding need to be solved. Solutions are proposed.Keywords: post-placental IUD, cesarean section, missing IUD threads, IUD expulsion, long-acting reversible contraception

【 授权许可】

Unknown