Comparative evaluation of postpartum IUCD versus interval IUCD at a tertiary care centre in Allahabad, India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20171423Keywords:
Cu T, Interval IUCD, PPIUCDAbstract
Background: The use of Cu T in postpartum period can provide long term and effective contraception and this study compares PPIUCD versus interval IUCD.
Methods: 300 women enrolled in the study were divided into two groups. Postpartum group-150; Postplacental or within 10 minutes/intracaesarean/within 48 hrs of delivery. Interval Group 150; after 6 weeks of delivery / postmenstrual. Cu T 380A was used in the study. Contraindication for PPIUCD were between 48 hrs and 6 wks postpartum, chorioaminionitis, PROM >18 hrs, unresolved PPH and puerperal sepsis. All were followed up for 6 months.
Results: The continuation rate at 6 months was 81.81% in interval group and 88.23% in postpartum group. Complications occurred in 15.33% cases after PPIUCD and in 19.33% cases after interval IUCD. Expulsion rate was significantly higher in PPIUCD as compared to interval insertions (6.96% v/s 2.2%; p value <0.05). Removal rate of IUCD was almost similar in both the groups (4% in PPIUCD v/s 6.0% in interval).
Conclusions: PPIUCD is an effective, safe, convenient, low cost and long term method of postpartum contraception irrespective of the mode of delivery.
References
Santhya KG. Changing Family Planning Scenario in India. Regional Health Forum WHO South-East Asia Region http://www.searo.who.int/en/Section1243/ Section 1310 / Section 1343 / Section1344/Section1836/Section1838.html , 2004 [cited 2012 May 4].;8(1).
India. National Family Health Survey-3. 2005-06 Available from: Government of India, Ministry of Health and family welfare Web site: www.nfhsindia.org/factsheet.html. cited 2012 May 3.
Xu JX, Rivera R, Dunson TR, Zhuang LQ, Yang XL and Ma GT. A comparative study of two techniques used in immediate post placental insertion (IPPI) of the Copper T 380A IUD in Shanghai, People‘s Republic of China. Contraception 1996;54(1):33-8.
Morrison C, Waszak C, Katz K, Diabate F, Mate EM. Clinical outcomes of two early postpartum IUD insertion programs in Africa. Contraception. 1996;53(1):17-21.
Celen S, Moroy P, Sucak A, Aktulay A, Danisman N. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contraception. 2004;69:279-82.
Singal S, Bharti R, Dewan R, Divya, Dabral A, Batra A, Sharma M, Mittal P: Clinical Outcome of Postplacental Copper T 380A Insertion in Women Delivering by Caesarean: J Clin Diagn Res. 2014;8(9):OC01-4.
Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80(4):327–36.
Gupta G, Goyal R, Kadam VK, Sharma P1. The Clinical Outcome of Post Placental Copper-T-380A Insertion with Long Placental Forceps (Kelly's Forceps) After Normal Vaginal Delivery and Caesarean Section: J Obstet Gynaecol India. 2015;65(6):386-8.
Eroglu K, Akkuzu G, Vural G, Dilbaz B, Akin A, Taskin 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;74:376-81.
Shukla M, Qureshi S, Chandravati: Post placental intrauterine device insertion-a five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136:432-5.
Bonilla Rosales F, Aguilar Zamudio ME, Cazares Montero ML, Hernandez Ortiz ME, Luna Ruiz MA. Factors for expulsion of intrauterine device TCu380A applied immediately postpartum and after a delayed period. Rev Méd Inst Mex Seguro Soc. 2005;43:5-10.
El Beltagy NS, Darwish EA, Kasem MS, Hefila NM. Comparison between cupper T380 Iud and multi load 375 Iud in early post‐partum insertion. Middle East Fertility Society J. 2010;16:143‐8.
Tatum HJ, Beltran RS, Ramos R, Van KH, Sivin I, Schmidt FH. Immediate post placental insertion of GYNE-T 380 and GYNE-T 380 Postpartum intrauterine contraceptive devices: Randomized study. Am J Obstet and Gynecol. 1996;175(5):1231-5.
Thiery M, Van DPH, Delbeke L, Van KH. Comparative performance of two copper-wired IUDs (ML Cu 250 and T Cu 200). Immediate postpartum and interval insertion. Contracept Deliv Sys. 1980;1(1):27-35.
