Five-year follow-up of two types of contraceptive device fitted during elective cesarean delivery

To present follow-up data for patients fitted with a copper intrauterine contraceptive device (IUCD) or the levonorgestrel intrauterine system (IUS) during cesarean delivery.

Between March 2006 and December 2011, a prospective study was undertaken of women who were scheduled to have a repeat cesarean for a singleton pregnancy and had chosen to undergo intraoperative fitting of an IUCD or the IUS. Participants were followed up for up to 5 years using transvaginal ultrasonography, clinical evaluation, and a questionnaire.

Among 143 participants, 63 requested the IUCD and 80 the IUS. Misalignment was more common at 6 weeks with the IUS (37 [46.3%] patients) than with the IUCD (22 [34.9%]; P=0.06). Spontaneous expulsion occurred in the IUCD group only (4 [6.3%] patients). No pregnancies were reported in the IUS group, whereas 4 (6.3%) women with the IUCD became pregnant.

Although misalignment of an IUCD or the IUS is fairly common after intraoperative insertion, the contraceptive performance and menstrual pattern are not affected. Therefore, there is no need to remove or replace a misaligned IUCD or IUS.