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    Jurnal IUD

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    sarnisyah
    The document compares the Cu T380 IUD and Multiload 375 IUD for early postpartum insertion within 48 hours of delivery. 300 women were included in the study, with 150 receiving each IUD type. There was no significant difference in characteristics between the groups. Expulsion rates at 6 months were 15% for Cu T380 and 14.9% for Multiload 375, with a higher rate of bleeding abnormalities found for Multiload 375. While expulsion rates were relatively high, the study outcomes indicate postpartum IUD insertion is generally safe and effective compared to interval insertion.

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    Jurnal IUD

    Uploaded by

    sarnisyah
    48 views26 pages
    The document compares the Cu T380 IUD and Multiload 375 IUD for early postpartum insertion within 48 hours of delivery. 300 women were included in the study, with 150 receiving each IUD type. There was no significant difference in characteristics between the groups. Expulsion rates at 6 months were 15% for Cu T380 and 14.9% for Multiload 375, with a higher rate of bleeding abnormalities found for Multiload 375. While expulsion rates were relatively high, the study outcomes indicate postpartum IUD insertion is generally safe and effective compared to interval insertion.

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    The document compares the Cu T380 IUD and Multiload 375 IUD for early postpartum insertion within 48 hours of delivery. 300 women were included in the study, with 150 receiving each IUD type. There was no significant difference in characteristics between the groups. Expulsion rates at 6 months were 15% for Cu T380 and 14.9% for Multiload 375, with a higher rate of bleeding abnormalities found for Multiload 375. While expulsion rates were relatively high, the study outcomes indicate postpartum IUD insertion is generally safe and effective compared to interval insertion.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    48 views26 pages

    Jurnal IUD

    Uploaded by

    sarnisyah
    The document compares the Cu T380 IUD and Multiload 375 IUD for early postpartum insertion within 48 hours of delivery. 300 women were included in the study, with 150 receiving each IUD type. There was no significant difference in characteristics between the groups. Expulsion rates at 6 months were 15% for Cu T380 and 14.9% for Multiload 375, with a higher rate of bleeding abnormalities found for Multiload 375. While expulsion rates were relatively high, the study outcomes indicate postpartum IUD insertion is generally safe and effective compared to interval insertion.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 26

    Comparison between Cupper

    T380 IUD and Multiload 375


    IUD in early post partum
    insertion
    (N.S. El Beltagy , E.A. Darwish , M.S. Kasem ,
    N.M. Hefila)
    Hairunnisa
    Dr. dr. Eddy R Moeljono, SpOG
    (K)
    2

    INTRODUCTION

    » An intrauterine device (IUD) is the most frequently used


    reversible family planning method in the world. It offers safe,
    effective, and long term contraception
    » The Multiload 375 IUD and the Cu T380 IUD are more
    effective than barrier methods and are about as effective as
    injectables, implants, and voluntary sterilization
    » In general, IUDs can be inserted at any time during the menstrual
    cycle, if the woman is not pregnant, or It can also be inserted
    within the first 48 h postpartum or within 4 weeks
    postpartum
    3

    Introduction
    Postpartum period is defined as the first 6 weeks following delivery.
    Postpartum IUD insertion is divided as follows:
    » 1st, post placental IUD insertion within 10 min after placental
    expulsion;
    » 2nd early postpartum IUD insertion after 10 min of placental
    expulsion and within 48 h following delivery and before hospital
    discharge;
    » 3rd late postpartum IUD insertion within 6 weeks following delivery;
    and
    » 4th, delayed or interval postpartum IUD insertion after 6 weeks
    following delivery
    4

    Purpose
    To compare two types of intrauterine
    devices inserted in early postpartum period,
    namely Cu T380 IUD and Multiload 375
    IUD, in regard to safety, efficacy, side
    effects, and complications
    5

    Methods
    Population
    Sample Size
    Flow Chart Study
    Statistical Methodology
    6

    Population
    Three hundred (300) women attending El-Shatby Maternity University
    Hospital for normal delivery were included in a prospective study

    Sample Size
    Calculated (using the commercially available software EPI INFO) to
    be 150 participants in each group.
    7

    Flow Chart
    of the Study
    8

    Methods (cont…)

    » Using Kelly’s forceps under strict aseptic procedures,


    within 48 h of vaginal delivery, and after exclusion of any
    contraindications of using an IUD.
    » Fundal placement with Kelly’s forceps for insertion of
    IUDs was confirmed by abdominal ultrasonography.
    » The proper fundal placement of the IUD was achieved if
    the distance between the top of the IUD and the
    endometrium at the fundus of the uterus was 10 mm or
    less.
    9

    Methods (cont…)

    All women were instructed to return for review after


    6 weeks and after 6 months of IUD insertion.
    Pelvic ultrasound examination, using both
    abdominal and vaginal probes, was done in each
    visit to assess IUD endometrial distance.
    10

    Statistical Methodology
    » Using SPSS (Statistical Package of the Social
    Sciences) version 13 for Windows.
    » Data were checked for accuracy and for normality,
    using Kolmogrov- Smimov and Sharpiro-Wilk tests.
    » Qualitative variables were expressed as numbers and
    percentages, while quantitative variables were
    expressed as means and standard deviations.
    11

    Statistical Methodology
    The following statistical tests were used:
    a. Independent samples t-test as a parametric test of significance
    for comparison between two sample means, after performing
    the Leven’s test for equality of variance.
    b. McNemar’s Chi-square (v2) test for paired comparison of
    dichotomous variables.
    c. Fisher’s exact test.
    d. Pearson correlation.
    Level of significance equal to 0.05 was required for statistical
    significance
    12

    Results
    In the Cu T380 IUD group, 64% of the
    There
    womenwas were nofully
    statistically
    lactating, significant
    and 28.7%
    difference
    were partiallyconcerning these variables between
    lactating. In the Multiload 375
    the two studied groups in characteristics including
    IUDgravidity,
    age, group, and45% of the
    parity women
    of the Cu T380were
    IUD fully
    users
    lactating, and and37.3% were375
    Multiload partially lactating
    14

    Among
    Among
    There wastheaCu
    the Multiload
    T380 IUD 375
    statistically IUD group,
    group, 41%
    81% of
    significant the
    of them were
    women
    difference usingthe
    between contraceptives before,
    groups in regard to
    and 95.1%
    61.7% history
    contraceptive of them(pwere using an IUD
    <0.001)
    before current
    beforepregnancy
    conception.but stopped
    using contraception in order to conceive
    15

    The expulsion rates were relatively


    high but not significant for both IUDs at
    the 6-month follow-up visit, with the
    expulsion rate for Cu T380 users at 15%
    versus at 14.9% for Multiload 375 users
    16

    When utilizing a 10 mm as a cutoff point, it was


    found that there was a significant direct
    relation between the incidence of IUD expulsion in
    early postpartum insertion and the IUD
    endometrial distance at the uterine fundus
    measured by ultrasound during the two follow-up
    visits at 6 weeks and 6 months after IUD insertion
    17

    Discussi
    ons
    18

    Discussions (cont…)

    » An intrauterine device is an effective method for fertility


    regulation.
    » The early postpartum insertion of IUDs (i.e. relatively
    within 48 h after delivery and before hospital discharge)
    would be suitable because the cervix is patulous and the
    lochia will mask any bleeding associated with the IUD
    insertion
    19

    Expulsion Rate

    » This study revealed that the expulsion rate


    was fairly high in Cu T380 and
    Multiload 375 IUD users at 6 weeks (8.1%
    and 5.4%, respectively) and even higher
    at 6 months (15% and 14.9%,
    respectively) when compared to interval
    IUD insertion
    20

    Bleeding Abnormalities

    » At 6 months, the bleeding abnormalities were


    higher among the Multiload 375 IUD
    menstruating users than the Cu T380IUD
    » Roberto-Flores and others found, in their 3-year
    study, that bleeding following early postpartum IUD
    insertion is more intense with the Cu T380
    IUD than with the Multiload 375 IUD
    21

    Expulsion rate
    » At the 6-month follow-up visit, the expulsion rates were
    relatively high with both IUDs (the rate was 15%, versus
    14.9%)
    » The high expulsion rates in our study may relate to
    differences in the techniques used for IUD insertion.
    » Kulier found the same research results by comparing
    the Multiload 375 IUD and the Cu T380 IUD which were
    inserted during early post partum and in regard to the
    1-year expulsion and efficacy rates of these two IUDs.
    No statistically significant differences were found
    22

    Expulsion Rate

    » Prager 2007 : Higher IUD Expulsion (5,2% and 3,


    Vs IUD9 % for Multiload 375 in an early
    postpartum IUD insertion during 5 year period
    » WHO : 37% and 41% expulsion rates for
    immediate and early postpartum IUD insertion
    23

    Complications
    » No Case of Pregnancy, and Uterine perforations
    » 1 Case of PID in Multiload 375 IUD users 6 months
    after insertion
    » Standford and Mikolajczyk reported 6 cases of PID
    per 1000 women among IUD users in early post
    partum insertion following normal vaginal insertion
    in Africa
    The outcomes of our study indicate that 24

    postpartum IUD
    insertions, including early
    postpartum insertion, are generally
    safe and effective. Compared with interval
    insertions, postpartum insertions do not
    increase the risk of infection, bleeding, uterine
    perforation, or endometritis. As well, the return
    of the uterus to its normal size is not hindered
    25
    Thank You

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