Puerperal and menstrual bleeding patterns with different types of contraceptive device fitted during elective cesarean delivery
Elsedeek, M.S.E.
International Journal of Gynaecology and Obstetrics the Official Organ of the International Federation of Gynaecology and Obstetrics 116(1): 31-34
2012
ISSN/ISBN: 1879-3479 PMID: 22036512 DOI: 10.1016/j.ijgo.2011.07.036Document Number: 223691
To evaluate the impact of a copper-containing intrauterine contraceptive device (IUCD) and the levonorgestrel-releasing intrauterine system (IUS) on puerperal and menstrual bleeding when fitted intraoperatively during scheduled elective cesarean. Participants were allocated to 3 groups: cesarean with no device inserted; IUCD inserted during cesarean; and IUS inserted during cesarean. There was significantly shorter and lighter puerperium in the IUS group (20.2 ± 7.7 days and 3.1 ± 1.6 pads/day) than in the IUCD (33.4 ± 9.5 days and 4.9 ± 2.4 pads/day) and the control (27.0 ± 11.4 days and 4.9 ± 2.3 pads/day) groups (P<0.012 and P<0.0001, respectively). At the end of puerperium, mean duration of amenorrhea was significantly longer in the IUS group than in the IUCD and control groups (P<0.0001). Menstrual periods were longer and heavier in the IUCD group than in the control group but the difference was not significant (P>0.07). In the IUS group, menstrual periods were significantly shorter and lighter than in the other groups (P<0.0001). Intrauterine system fitting at the time of elective cesarean is associated with significant reductions in the duration and amount of puerperal blood loss, as well as a high incidence of amenorrhea and lighter periods thereafter.
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