Clinical outcome of post placental copper T380A and copper 375 IUCD insertion in women delivering by caesarean section

Divya Divya., Rupali Dewan


Background: The objective of the study was to compare the clinical outcome (safety, efficacy, expulsion and continuation rates) of post placental insertion of Cu375 and CuT380A intrauterine contraceptive devices (IUCD) in primiparous women undergoing caesarean section.

Methods: This was a prospective, randomized comparative study in which 300 primiparous women were recruited. All these women had post placental intracaesarean insertion of CuT 380A or Cu375 IUCD. Follow up visits were scheduled   at 1, 3 months, 6 month and 12 months.

Results: Mean age was 23.1 years. Visibility of strings increased in successive follow up visits and was visible in 97.1% of women at the end of one year and 72.3% in CuT380A IUCD users at 12 months. Menorrhagia was reported in 8.6% in Cu375 IUCD users and   10% in CuT380A IUCD users at the end of 1 year of follow up. There were only 10 expulsions of Cu375 IUCD and six that of CuT380A IUCD. Removal rate in was 7.3% in Cu375 users and 6.7% in CuT380A users. Overall 84.7% of the women were satisfied with the treatment and 60% to an extent that they would like to recommend it to others whereas 15.3% were not satisfied at all either due to adverse events or spontaneous expulsion of IUCD.

Conclusions: The Gross cumulative   continuation rates was   86% in women with   Cu375 IUCD insertions and 89.3% in CuT380A IUCD users. There was no significant difference between Cu375 and CuT380A regarding the safety, efficacy and complications.


Caesarean, Continuation rate, Expulsion, IUCD

Full Text:



Barett G, Peacock J, Victor CR, Manyonda I. Caesarean section and postnatal sexual health. Birth. 2003;32(4):306-11.

Mishra N, Dalal N, Joshi V. Intrauterine Device Insertion during Caesarean Section- A Boon for Rural Women. IOSR-JDMS. 2013;8(3):21-3.

Postpartum IUCD Reference Manual, New Delhi: Family Planning Division, Ministry of Health and Family Welfare, Government of India. 2010. Available at:

Bhutta SZ, Butt IJ, Bano K. Insertion of intrauterine contraceptive device at caesarean section. J Coll Physicians Surg Pak. 2011;21(9):527-30.

Levi E, Cantillo E, Ades V, Banks E, Murthy A. Immediate postplacental IUCD insertion at caesarean delivery: a prospective cohort study. Contraception. 2012;86(2):102-05.

Shukla M, Qureshi S, Chandrawati. Post-placental intrauterine device insertion--a five-year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136(3):432-5.

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80(4):327-36.

Cwiak C, Gellasch T, Zieman M. Peripartum contraceptive attitudes and practices. Contraception. 2004;70(5):383-6.

Thonneau PF, Almont T. Contraceptive efficacy of intrauterine devices. Am J Obstet Gynecol. 2008;198(3):248-53.

Kulier R, O’Brien PA, Helmerhorst FM, Usher-Patel M, D’Arcangues C. Copper containing, framed intra-uterine devices for contraception. Cochrane Database Syst Rev. 2007;(4):CD005347.

Eroglu K, Akkuzu G, Vural G, Dilbaz B, Akin A, Takin L, et al. Comparison of efficacy and complications of IUD insertion in immediate postplacental/early postpartum period with interval period: 1-year follow-up. Contraception. 2006;74(5):376-81.

Xu JX, Reusché C, Burdan A. Immediate postplacental insertion of the intrauterine device: a review of Chinese and the world’s experiences. Adv Contracept. 1994;10(1):71-82.

Celen S, Möröy P, Sucak A, Aktulay A, Daniman N. Clinical outcomes of early postplacental insertion of intrauterine contraceptive devices. Contraception. 2004;69(4):279-82.

Çelen, Sucak A, Yıldız Y, Danıman N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section. Contracep. 2011;84(3):240-43.

Long-acting reversible contraception the effective and appropriate use of long-acting reversible contraception. Regents Park, London: National Collaborating Centre for Women’s and Children’s Health Commissioned by the National Institute for Health and Clinical Excellence; 2005. October 2005.

Dahlke JD, Terpstra ER, Ramseyer AM, Busch JM, Rieg T, Magann EF. Postpartum insertion of levonorgestrel--intrauterine system at three time periods: a prospective randomized pilot study. Contracep. 2011;84(3):244-8.

El Beltagy NS, Darwish EA, Kasem MS, Hefila NM. Comparison between Cupper T380 IUD and Multiload 375 IUD in early post-partum insertion. Middle East Fertil Soc J. 2011;16(2):143-8.

Nelson AL, Chen S, Eden R intraoperative placement of CuT380intrauterine contraceptive devices in women undergoing elective caserean. Contraception. 2009;80(1):81-3.

Chi IC, Zhou SW, Balogh S, NG K. Post-cesarean section insertion of intrauterine devices. Am J Public Health. 1984;74(11):1281-2.

Arowojolu AO, Otolorin EO, Ladipo OA. Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial. Afr J Med Med Sci. 1995;24(1):59-65.

Lara R, Sanchez RA, Aznar R. Application of intrauterine device through the incision of the cesarean section. Gynecol and Obstet Mexico. 1989;57:23-7.

Wen Jin, Ying Li, You-ping Li, Li Wang, Comparative safety and effectiveness of TCu380A versus MLCu375: A systematic review of randomized trials J Evidence-Based Med. 2009;2,9(4):226-41.

Kumar M, Kumar M, Aggarwal P, Gangania A, Dewan R. A study to evaluate and compare the expulsion and continuation rates of post placental insertion of Cu 375 and CuT 380A in Indian women at a premier hospital in New Delhi, India. Int J Reprod Contracept Obstet Gynecol. 2017;6(9):3992-4000.