Copper T was inserted in 45 cases following caesarean section. Motivation was easier, acceptance was higher and follow-up was good in this group of patients. With proper selection and careful follow-up complications could be reduced to the minimum.
PIP: To assess the safety of insertion of the Copper T IUD after cesarean section, 45 women who underwent this process were followed for a period of 1-3 years. The majority of study participants were 26-30 years of age. 27 were para 1, 17 were para 2, and 1 was para 3. In 37 women, the IUD was inserted in tube postmenstrual phase. Complications occurring in this series were bleeding, pain, leukorrhea, perforation, and infection. The 1 case of perforation was diagnoses 1 1/2 years after IUD insertion when the patient requested removal to achieve pregnancy. The uterus was found to be hyperinvoluted. The case of pelvic infection also was revealed 1 1/2 years after insertion. This patient was treated with antibiotics and conceived 6 months after IUD removal. IUD expulsion occurred in 4 cases--2 within 5 days of insertion and 2 at 3 and 5 months after insertion. During the study period, 5 women had the device removed for reasons that included bleeding, formation of an adnexal lump, and desire for pregnancy. Notable in this series was an excessive bleeding rate of 6.6% compared to rates as high as 15% obtained in studies of IUD insertion after vaginal delivery. There were no ectopic pregnancies or contraception failures among women in this study. In general, it appears that the Copper T IUD is a safe contraceptive choice after cesarean section. However, given the risk of perforation or expulsion, the device is not recommended for women with a hyperinvoluted small uterus.