Observational studyInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2026
Association of novel intra-cesarean post-placental intrauterine device insertion techniques, and early ultrasound, with expulsion rates and strings visibility: A prospective exploratory study.
Observational study in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo assess an innovative technique of intra-cesarean post-placental insertion of the Copper T380A IUD (CPPIUD), and explore the role of predischarge ultrasound with replacement of low-lying IUDs.
methodsWe conducted a prospective observational study at Princess Marina Hospital, Gaborone, Botswana, from May 31, 2023, to April 3, 2024. Sixty-seven participants were recruited following CPPIUD. We compared the standard FIGO technique with a novel method in which the insertion straw was left in place to stabilize the IUD and strings during uterine and abdominal closure, then retrieved transvaginally (see youtube video https://www.youtube.com/watch?v=ToWkp3z0_Vg). Technique selection was according to the attending surgeons' personal preference. IUD placement was assessed by predischarge transabdominal ultrasound, and participants were followed up at 6 weeks or later. The primary outcome was IUD retention.
resultsOverall IUD retention was 63/67 (94.0%). The straw-stabilized group showed a slightly but not statistically significantly higher retention rate (97.9% vs. 85.0%) and string visibility (34.0% vs. 15.0%). Predischarge ultrasound identified low-lying IUDs in 7/67 participants (10.4%) across both groups; these devices were replaced. One spontaneous expulsion and three removals on request occurred after discharge.
conclusionThe straw-stabilized method is at least equivalent to the standard approach. Early predischarge ultrasound may enhance retention.
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