Comparative study of interval versus postpartum Cu-T insertion in a central referral hospital of North East India

Pesona Grace Lucksom, Bikram Kishore Kanungo, Nikhil Sebastian, Rashi Mehrotra, Dipika Pradhan, Rekha Upadhya

Abstract


Background: Aim of current study was to compare interval and postpartum Cu-T (380A) insertion in terms of safety and immediate outcome.

Methods: This was a retrospective cohort study where retrospective analysis of prospectively collected data in the department of OBG, SMIMS, Gangtok, from April 2011 to April 2012 were taken for evaluation. 164 women who were inserted Cu-T after delivery and in the interval period were studied. 80 were inserted Cu-T at post-partum period (36 after vaginal delivery and 44 intra caesarean) while 84 were inserted at interval period. Follow up was done at 6 weeks and 3 months. Outcome was measured by tail visibility at 6 weeks and 3 months, spontaneous expulsion rate, removal rate and perception of insertion using visual analog scale (0-5).

Results: Tail visibility at 6 weeks and 3 months was less in post-partum than that of interval insertion. Spontaneous expulsion rate was nil in post-partum while 5/84 (5.95%) in interval insertion. Perception of insertion for doctor and client was easiest in intra Caesarean (0) while difficult in interval (4). Removal rate was 1/80(1 %) in post-partum and 9/84 (10.7%) in interval.

Conclusions: Study suggested that post-partum insertion is more effective than interval Cu-T insertion with low expulsion rate and complications compared to interval insertion. 


Keywords


Cu-T, Removal, Acceptance, Advantages, Counselling

Full Text:

PDF

References


Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet. 2006;368:1810-27.

Winner B, Peipert JF, Zhao Q, Buckel C, Madden T, Allsworth JE, et al. Secura, GM. Effectiveness of long-acting reversible contraception. N Engl J Med. 2012;366(21):1998-2007.

Institute for Population Sciences (IIPS) and Macro International. National family health survey (NFHS-3), 2005-06, India, key findings. Mumbai, IIPS, 2007. Available at: http://www.measuredhs.com/pubs/pdf/SR128/SR128.pdf. Accessed 14 March 2013.

Borda M. Family planning needs during the extended postpartum period in India. Access family planning initiative brief, 2009. Available at: http://www.accesstohealth.org/toolres/pdfs/India_Analysis.pdf. Accessed 14 March 2013.

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.

World Health Organization. Medical eligibility criteria for contraceptive use. In: WHO, eds. WHO Material. Geneva: World Health Organization; 2010: 4.

Araujo VB, Ortiz L, Smith J. Postpartum IUD in Paraguay: a case series of 3000 cases. Contraception. 2012;86:173-86.

Blumenthal P, Shiliya N, Neukom J, Chilambwe J, Vwalika B, Prager B, et al. Expulsion rates and satisfaction levels among immediate postpartum IUD users in peri-urban Lusaka, Zambia. Contraception. 2011;84:320.

Grimes DA, Lopez LM, Schulz KF, Van Vliet HAAM, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2010;(5):CD003036.

Nathalie Kappa, Kathryn M. Curtis. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80:327-36.

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 Sep;136(3):432-5.

Akkuzu G, Vural G, Eroglu K, Dilbaz B, Taskin L, Akin A, et al. Reasons for continuation or discontinuation of IUD in postplacental/early postpartum periods and postpuerperal/interval periods: One-year follow-up. Turkiye Klinikleri J Med Sci. 2009;29(2):353-60.

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

Nelson AL, Chen S, Eden R. Intraoperative placement of the copper T-380 intrauterine devices in women undergoing elective cesarean delivery: a pilot study. Contraception. 2009 Jul;80(1):81-3.