Postplacental insertion of the spiked and the standard lipes loop in early postpartum contraception

ABSTRACT

This study included 158 women in 3 groups; [1] Group of 53 cases in whom the spiked Lippes loop was inserted immediately after delivery of the placenta, [2] Group of 55 cases in whom the standard Loop size D was inserted postplacentally, [3] Group of 50 women who delivered normally with no IUD insertion; control group. The cases were followed up after insertion for one year. Hysterograms were performed 6-9 months after insertion for 20 cases to study the relationship of the devices to the endometrial cavity. By the third month of insertion, 15.2% and 9.3% of the spiked and the standard loop users respectively stated that the menstrual bleeding was more than average. This decreased gradually with time. By the 12th month, the devices were removed from 4 cases due to the severity of bleeding, 2 cases in each group. Mild dysmenorrhea was observed in few cases. Regarding expulsion of the loop, complete expulsion occurred in one patient using the spiked and in cases using the standard loop in the first week after insertion. Partial expulsion occurred in one case using the spiked and in 4 cases using the standard loop. These were discovered at the 3-week follow up visit. Infection occurred in one case using the spiked loop on the 10th day of insertion and the device was removed. The discontinuation rates were 10/100 women for the spiked and 18/100 women for the standard loop in the first year of use. The hysterographic study of the cases showed that both the spiked and the standard loops were In proper position with no displacement inside the uterine cavity