Hang-up IUD, New Technique for Suturing CuT-380A IUD to Uterine Fundus in Immediate Postplacental Insertion during Cesarean Delivery: Twelve Months Follow up

• Main Authors: Hary Tjahjanto, Indah T Haryuni
• Format: Article
• Language: English
• Published: Indonesian Society of Obstetrics and Gynecology 2014-07-01
• Series: Indonesian Journal of Obstetrics and Gynecology
• Online Access: http://inajog.com/index.php/journal/article/view/395

Objective: The aim of this study was to evaluate the effectiveness, side effects and acceptability of postplacental CuT-380A IUD insertion using new technique for suturing to uterine fundus during cesarean section (hang up technique). Method: Prospective cohort study of postplacental IUD CuT-380A insertion during cesarean delivery. Hang-up technique consists of performing a puncture in the center of the fundus wall using straight needle into the uterine cavity and subsequently using chromic catgut no. 1 to tie the IUD using anchor knot and hanging the IUD to the fundus. Our subjects were women who underwent caesarean delivery at dr. Kariadi Hospital between 1st June 2009 to 31st April 2011 and followed up at <6 weeks, 6 weeks, 3 , 6, 9 and 12 months. Result: From 116 women, 8 women (7.4%) were lost to follow-up. The 108 women were observed by scheduled home visits or by mail or telephone. The youngest patient was 15 years old and the oldest was 40 years old. The proportion of primiparous and multiparous women was comparable (49.1% and 50.9%), gestational age was 28-44 weeks, birth weight ranged 2,950-4,500 grams. Six weeks post cesarean section, out of the 108 women, two women complained of foul-smelling lochia, two had puerperal fever, and three complained of pelvic pain. At 6-months follow-up, 3 women underwent IUD removal because two found the string very disturbing and the other wanted to get pregnant because their child died. At 9- months post-cesarean one woman was reported to be pregnant with IUD in situ. At >12 months follow-up, one woman underwent IUD removal because of severe dysmenorrhea. No perforation or expulsion was reported. Conclusion: Immediate postplacental insertion of IUD CuT-380A using hang-up technique is safe and effective. Typical use effectiveness is high (Pearl Index 0.93) and there were no reported incidents of expulsion or perforation. Acceptance and continuation rate were high, 98.15% and 95.37% respectively. Keywords: anchor knots, cesarean section, hang-up IUD, postplacental IUD insertion