Post-partum bleeding and infection after post-placental IUD insertion

The incidence of excessive bleeding and endometritis in 145 women who accep ted post-placental insertion of a copper T380A intrauterine device (IUD) wa s compared with that of 157 subjects who did not accept the insertion of th e IUD. The subjects delivered at the Maternidade da Encruzilhada, Recife, B razil in the period from March 30, 1994, to December 15, 1995. A blood samp le for hemoglobin was collected before placental expulsion and 10 days afte r labor. The IUD was inserted up to 10 min after the expulsion of the place nta. There was no difference between the groups in the incidence of excessi ve bleeding, neither regarding mean hemoglobin concentration before placent al expulsion (t = 0.039; p = 0.83) nor at day 10 postpartum (t = 1.04: p = 0.29). There were 5 cases of clinically diagnosed endometritis among the 14 5 subjects with placental-IUD (3.4%) and 7 cases among the 157 women withou t IUD (4.5%) (p = 0.40). Post-placental insertion appears to be a convenien t approach to IUD initiation, with no observed increase in the incidence of excessive bleeding or endometritis. (C) 2001 Elsevier Science Inc. All rig hts reserved.