[IUD insertion during cesarean section and its most frequent complications]. / DIU transcesárea y sus complicaciones más frecuentes.

ABSTRACT

PIP: 78 women were fitted with copper T 220 IUDs during cesarean deliveries at a Mexican Institute of Social Security hospital in Cardenas, Tabasco, between August 1991 and December 1992 in a study of the suitability of IUD insertion during cesareans. A control group consisted of 74 women undergoing cesarean deliveries who did not have IUDs inserted. The average age was 20.6 years for IUD acceptors and 24.9 years for controls. The average number of pregnancies including the current one was 1.3 for the IUD group and 3.2 for the control group. Average gestational age at the time of delivery was 38.5 weeks for the IUD group and 40.1 weeks for the control group. The indication for cesarean was fetopelvic disproportion for 51.2% of the IUD group and 40.5% of controls. The volume of bleeding was normal for 98.7% of IUD acceptors and all in the control group. The IUD was vaginally removed two hours postpartum in the one IUD acceptor with postpartum hemorrhage. The average duration of bleeding was 23.8 days for the IUD group and 22.0 days for the control group. Pain during the postpartum period was described as light for 91.0% and moderate for 9.0% in the IUD group and as light for 93.2% and moderate for 6.8% in the control group. Four cases of endometritis (5.1%) were observed in the IUD group. Three cases of endometritis and one of abscess of the abdominal incision were observed in the control group, for an overall infection rate of 5.4%. One IUD expulsion occurred on the fifteenth postpartum day, for a rate of 1.28%. The strings could be seen in only 21.7% of cases at the six-week check-up. The IUD was visualized by X-ray for 71.7% at the control visit. IUD insertion did not significantly increase postoperative pain, hospital stay, the volume or duration of bleeding, or frequency of infection. The results suggest that IUD insertion during cesarean is a safe and effective method of fertility control for patients at high reproductive risk.