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Introduction: The copper-containing intra-uterine device IUD (cIUD) is a non-hormonal, effective, long-acting method of contraception, which is not widely used in nulliparous patients in France. The objectives of the study are to compare the safety of the cIUD by the rate of continuation at 6 months between nulliparous and parous patients, and to assess the complications and side effects at insertion and during follow-up. Material and method This is a multicenter prospective epidemiological study with follow-up for 6 months. The adult patients were included in Nantes from February 2019 to October 2019 during the insertion of a IUD in different centers: the student health service (SUMPPS) (Nantes), the Clotilde de Vautier center in the Clinic Jules Verne (Nantes) and in the gynecological offices of the city of Nantes., Results: A total of 94 patients were included during the insertion of the cIUD. At 6 months, 77 patients answered the second questionnaire, 49 patients were nulliparous and 28 were parous. The pain on insertion was greater in nulliparous patients with a VAS of 6.5±2.4 (0-10) versus 3.9±2.2 (0-8) for multiparous patients (P<10 -4 ). The 6-month continuation rate for the cIUD was 92.8% for 83.4% for nulliparous patients, and parous patients with no significant difference (P=0.25). Expulsion was the only complication found with 12.2% in nulliparous and 3.5% in parous (P=0.40). Otherwise, 64% of the patients observed heavy bleeding than before without difference with the parity, and 72% of the nulliparous declared to have dysmenorrhea requiring the use of analgesics, against 47% of the parous (P=0.025). The nulliparous were very satisfied or satisfied for 89% in daily life and 96% of them in sex life, without difference compared to parous (97% and 100% respectively)., Conclusion: There is no difference in the rate of continuation at 6 months between nulliparous and parous. Nulliparous complained more often of dysmenorrhea in comparison to the period before the cIUD. The satisfaction rates were comparable., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Objectives: Evaluate an educational program based on "CLEAR" (Cervical Length Education and Review) in the teaching of measuring sonographic cervical length to residents in gynecology and obstetrics., Methods: This is a prospective cohort study in a tertiary care center between May and November 2017. The residents were asked to collect 5 cervical length images from patients suspected with threatened preterm labor. A theoretical session on cervix measurement image criteria based on "CLEAR" program was taught to all residents. Then, they had to collect 5 new cervical length images. All the images were reviewed by two experienced reviewers, blinded to the resident and whether the image was obtained before or after the theoretical session and based on 8 criteria., Results: Ten residents participated to the study. The mean total score CLEAR was significantly higher post-intervention: 6.6±0.9 vs. 4.3±2.1, positive difference of 2.3±2.3 (P<0.001). Improvement was most significant with the junior residents: 3.6 pre vs. 6.5 post-intervention., Conclusion: Educational program based on CLEAR criteria allowed to improve the competence of residents in measuring sonographic cervical length, although this can also be correlated with the progression of residents during the semester. It could be implemented systematically with the aim of CLEAR certification to standardize the teaching of residents in gynecology and obstetrics., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)