***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To compare the expulsion rate of Nova-T380 , Multiload 375 , and Copper-T380A intrauterine contraceptive devices ( IUCDs ) inserted during cesarean delivery . METHODS A comparative r and omized study was conducted between January 1 , 2013 , and June 30 , 2014 , in three maternity centers in Egypt and Saudi Arabia . All women scheduled for an elective cesarean and accepting intraoperative insertion of an IUCD  were r and omly allocated to receive the Nova-T380 ( group 1 ) , Multiload 375 ( group 2 ) , or Cu-T380A ( group 3 ) using a computer-generated table . Research ers and participants were not masked to the type of IUCD . Follow-up was for 1 year . The primary outcome was IUCD expulsion ( complete or partial [ i.e. displacement ] ) . RESULTS Each group contained 40 participants . At 1 year , expulsion had been reported for 5 ( 13 % ) women in group 1 , 2 ( 5 % ) in group 2 , and 6 ( 15 % ) in group 3 ( P>0.05 for all ) . The frequency of displacement was significantly lower in group 2 ( 5 [ 13 % ] participants ) than in group 1 ( 15 [ 38 % ] ; P=0.001 ) and group 3 ( 14 [ 35 % ] ; P=0.008 ) . CONCLUSION Despite a comparable risk of expulsion following IUCD insertion during cesarean delivery , the Multiload 375 device showed the lowest risk of displacement Intrauterine devices ( IUDs ) were applied in 554 women during cesarean sections and the results were compared with the event rates presented in 804 women who received the IUD vaginally immediately postpartum . The expulsion rates at one month were 4.1 for the IUD inserted during the cesarean section and 7.5 for the post partum IUD . The expulsion rates at three months were 10.9 and 16.4 respectively . In a third group of 240 women who had cesarean sections but did not accept the IUD for contraception , the rate of endometritis at one month result ed in 0.8 compared with 1.1 for the group of cesarean section with IUD . Almost two thirds of the cesarean sections in both groups were performed on emergency bases . The application of the transcesarean IUD is considered to be safe procedure for fertility control Abstract Objective To investigate whether sublingual misoprostol administered one hour before intrauterine device ( IUD ) insertion reduces failed insertions , insertion-related complications and pain in parous women delivered only by elective caesarean section ( CS ) . Methods Single-blind r and omised controlled trial conducted in Ismailia , Egypt , between July 2010 and December 2011 . Women who had never delivered otherwise than by elective CS and desirous of using an IUD were r and omly allocated to receive sublingually 400 μg misoprostol and 100 mg diclofenac ( misoprostol group ) or 100 mg diclofenac alone ( control group ) one hour before IUD insertion . Outcome measures were failed insertion , ease of insertion judged by the investigators , insertion-related complications , and patients ’ satisfaction . Results In all , 255 women ( 130 and 125 in the study and control groups , respectively ) had an IUD inserted . Seven insertions failed : five in the control group , and two in the study group . Ease of insertion and patients ’ satisfaction were comparable in both groups . Abdominal pain and nausea were the commonest side effects reported in the misoprostol group . Conclusion Sublingual administration of misoprostol one hour before IUD insertion in parous women with no previous vaginal delivery does not facilitate the procedure and may cause undesirable side effects . This approach is not recommended as a st and ard treatment OBJECTIVES To compare rates of  Copper T380A intrauterine device ( IUD ) utilization and satisfaction with immediate versus delayed IUD insertion  after cesarean delivery in Kampala , Ug and a. METHODS This study was a r and omized clinical trial of women undergoing cesarean section who desired an IUD in Kampala , Ug and a. Participants were r and omly assigned to IUD insertion at the time of cesarean delivery or 6weeks afterward . The primary outcome was IUD utilization at 6months after delivery . RESULTS Among 68 women who underwent r and omization , an IUD was inserted in 100 % ( 34/34 ) of the women in the immediate insertion group and in 53 % ( 18/34 ) in the delayed group . IUD use at 6 months was higher in the immediate insertion group ( 93 % vs. 50 % after delayed insertion ; p<.0001 ) . Infection and expulsion were rare and did not differ between groups . When we pooled both groups and looked at IUD users compared to nonusers , 91 % ( 39/43 ) of IUD users were satisfied or very satisfied with their contraceptive method compared to 44 % ( 11/25 ) of nonusers ( p<.0001 ) . Women who chose not to be in the study or had the IUD removed often did so because of perceived husb and or community disapproval . CONCLUSION The 6-month utilization of an IUD after immediate insertion was significantly higher than after delayed insertion without increased complications . Contraceptive satisfaction was significantly higher among IUD users than nonusers . Community and husb and attitudes influence IUD utilization and continuation in Kampala , Ug and a. IMPLICATION S This work is important because it shows the safety and efficacy of providing IUDs during cesarean section in a setting where access to any healthcare , including contraception , can be extremely limited outside of childbearing and the consequences of an unintended , closely spaced pregnancy after a cesarean section can be life threatening BACKGROUND The rate of unintended pregnancy in the United States is much higher than in other developed nations . Approximately half of unintended pregnancies are due to contraceptive failure , largely owing to inconsistent or incorrect use . METHODS We design ed a large prospect i ve cohort study to promote the use of long-acting reversible contraceptive methods as a means of reducing unintended pregnancies in our region . Participants were provided with reversible contraception of their choice at no cost . We compared the rate of failure of long-acting reversible contraception ( intrauterine devices [ IUDs ] and implants ) with other commonly prescribed contraceptive methods ( oral contraceptive pills , transdermal patch , contraceptive vaginal ring , and depot medroxyprogesterone acetate [ DMPA ] injection ) in the overall cohort and in groups stratified according to age ( less than 21 years of age vs. 21 years or older ) . RESULTS Among the 7486 participants included in this analysis , we identified 334 unintended pregnancies .  The contraceptive failure rate among participants using pills , patch , or ring was 4.55 per 100 participant-years , as compared with 0.27 among participants using long-acting reversible contraception ( hazard ratio after adjustment for age , educational level , and history with respect to unintended pregnancy , 21.8 ; 95 % confidence interval , 13.7 to 34.9 ) . Among participants who used pills , patch , or ring , those who were less than 21 years of age had a risk of unintended pregnancy that was almost twice as high as the risk among older participants . Rates of unintended pregnancy were similarly low among participants using DMPA injection and those using an IUD or implant , regardless of age . CONCLUSIONS The effectiveness of long-acting reversible contraception is superior to that of contraceptive pills , patch , or ring and is not altered in adolescents and young women . ( Funded by the Susan Thompson Buffet Foundation . ) INTRODUCTION Short interconception period after caesarean section and its associated risk of increased morbidity , mortality and surgical interventions could be avoided by postplacental IUCD insertion during the procedure . Despite the safety reports on intracaesarean IUCD insertion , obstetricians are still hesitant to extend the benefit of this long acting reversible contraception to women undergoing operative delivery . OBJECTIVE To study the clinical outcome ( safety , efficacy , expulsion and continuation rates ) of postplacental Copper T 380A insertion in primiparous women undergoing caesarean section . MATERIAL S AND METHODS This study was a prospect i ve observational study , carried out in the Department of Obstetrics and Gynaecology , Sa fda rjung hospital , which is a tertiary care hospital of Northern India . Primiparous women who delivered by caesarean section over a period of six months ( July 2012 to December 2012 ) , willing for postplacental intracaesarean IUCD insertion , and willing to comply with the study protocol , were recruited for the study . All these subjects fulfilled the WHO St and ard Medical Criteria for PPIUCD insertion ; follow up visits were scheduled at 1 , 3 , 6 and 12 months . RESULTS A total of 300 primiparous women underwent postpartum  intracaesarean insertion of Copper T 380A .  The mean age of women included in the study was 23.12 ± 2.42 years . Most common postinsertion complication observed in the immediate postoperative period was febrile morbidity ( 2 % ) . Majority of women ( 94.33 % ) had hospital stay of less than 4 days . The common adverse events observed during follow-up of 12 months were menstrual complaints , excessive vaginal discharge and persistent pelvic pain . At the end of one year , there were 16 expulsions , 21 removals , and 2 pregnancies with gross cumulative expulsion , removal , failure and continuation rates of 5.33 % , 7 % , 0.67 % and 91 % , respectively . CONCLUSION Postplacental intracaesarean Copper T 380A insertion in primiparous women is a safe and effective method of reversible contraception , with low expulsion and high continuation rates A prospect i ve and cooperative study was done in 152 patients that were su bmi tted to cesarean section .  Seventy eight patients received intrauterine device ( IUD ) T CU 220 during cesarean section , and the other 74 patients only got the cesarean section without IUD . The events that were analyzed during the puerperium were pain , bleeding and infection . We did n't find any difference in the results between both groups , these were analyzed with the help of the square chi ( X2 ) . These results suggest that with an adequate selection of the patients , the insertion of the IUD during the cesarean section is a secure and helpful method for the fertility control for patients with high risk of reproduction OBJECTIVE To present follow-up data for patients fitted with a copper intrauterine contraceptive device ( IUCD ) or the levonorgestrel intrauterine system ( IUS ) during cesarean delivery . METHODS Between March 2006 and December 2011 , a prospect i ve study was undertaken of women who were scheduled to have a repeat cesarean for a singleton pregnancy and had chosen to undergo intraoperative fitting of an IUCD or the IUS .  Participants were followed up for up to 5 years using transvaginal ultrasonography , clinical evaluation , and a question naire . RESULTS Among 143 participants , 63 requested the IUCD and 80 the IUS .  Misalignment was more common at 6 weeks with the IUS ( 37 [ 46.3 % ] patients ) than with the IUCD ( 22 [ 34.9 % ] ; P=0.06 ) . Spontaneous expulsion occurred in the IUCD group only ( 4 [ 6.3 % ] patients ) . No pregnancies were reported in the IUS group , whereas 4 ( 6.3 % ) women with the IUCD became pregnant . CONCLUSION Although misalignment of an IUCD or the IUS is fairly common after intraoperative insertion , the contraceptive performance and menstrual pattern are not affected . Therefore , there is no need to remove or replace a misaligned IUCD or IUS OBJECTIVES The safety and efficacy of a single-rod implantable contraceptive containing etonogestrel ( Implanontrade mark ) were investigated in a multicenter clinical trial . STUDY DESIGN Sexually active American women ( N=330 ) with apparently normal menstrual cycles used the implant for up to 2 years . All subjects recorded bleeding and /or spotting daily in a diary . Safety was assessed through adverse experiences ( AEs ) , laboratory tests and physical and gynecologic examinations . RESULTS Total exposure was 474 woman-years ( 6186 cycles ) , and 68 % of subjects had at least 1 year of exposure . No pregnancies occurred . The most common bleeding pattern observed throughout the study was infrequent bleeding , defined as less than three episodes of bleeding in a reference period ( excluding amenorrhea ) . The least common pattern was frequent bleeding , defined as more than five episodes of bleeding in a reference period . Infrequent , prolonged and frequent bleeding patterns were most common early in the study and declined thereafter . During the 3-month Reference Periods 2 - 8 ( Months 4 - 24 ) , the incidence of amenorrhea ranged from 14 % to 20 % . Forty-three subjects ( 13 % ) withdrew from the study because of bleeding pattern changes and 76 subjects ( 23 % ) discontinued because of other AEs . Other common AEs leading to discontinuation , besides bleeding irregularities , were emotional lability ( 6.1 % ) , weight increase ( 3.3 % ) , depression ( 2. 
    Output:
    
The IUD is a long-acting reversible contraceptive method that is suitable for use in all women undergoing CS .