الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
I
UDs are highly, if not the most effective method of contraception with typical use related failure rates of between 0.2-0.8% (American Congress of Obstetricians and Gynecologists, 2012). Difficulties with IUD insertion, failure and complications can lead to decreasing utilization of such an effective method (Bahammondes et al., 2015).
The intrauterine position of an intrauterine contraceptive device is thought to be closely related to its contraceptive power. In the first year after insertion, between 5 and 15% of women will have their IUD removed because of irregular uterine bleeding which have been attributed to the effect of contact between the device and the endometrium and even the pressure on the uterine muscle. The disharmonious relationship between the IUD and the uterus is the cause of most of the bleeding complaints, so bleeding is related to improper position rather than the contraceptive method itself which should be excluded before abandoning the IUD for any other method of birth control (Kroon et al., 2003).
Ultrasonography of the pelvis and especially the transvaginal route, plays an essential role in evaluating the IUD position (Peri et al., 2007) and it’s potential complications, thus is considered the gold standard for this gynaecological condition (Nowitzki et al., 2015).
This randomized clinical trial was conducted at Ain Shams University Maternity Hospital in Birth Control Clinic between August 2016 and April 2017 To compare between ultrasound guided and blind IUD insertion technique as regards proper fundal location of IUD, incidence of complications, time consumption and patient satisfaction. A total of 100 candidate for IUD insertion was randomly distributed into two groups 50 in each. group B: Using the blind technique for IUD insertion. group U: Using ultrasound guided technique for IUD insertion.
Upon cusco opening and visualization of the cervix in both groups, a stopwatch was started. The stopwatch was stopped once the practitioner completed the procedure with cusco removal.
Trans-vaginal ultrasonography was done for every patient in both groups at ultrasound unit-Ain Shams Maternity Hospital to assess the IUD position post-insertion. Patients were instructed to return to the study institution after the next menstruation and device positioning was confirmed by another trams-vaginal ultrasonography.
Results:
Proper Fundal distances after insertion were significantly more frequent among group U than among group B(.p=0.009) and the over all complications were significantly less frequent in group U than in group B.(P=0.016). Also pain perceiption (VAS-100), procedure duration and unsatisfaction were significantly lower among group U than among group B.
These results point out that In women undergoing IUD insertion, ultrasound guided insertion is more effective, safe, less painful, less time consuming and result in better patient satisfaction.