A study to evaluate safety and efficacy of immediate postpartum postplacental IUCD insertion
Keywords:Copper T 380A, Immediate postplacental insertion, Intracesarean insertion, Postpartum intrauterine contraceptive device
Background: The postpartum period is an important time in a woman’s life to promote the health of the newborn and the mother. In INDIA, the unmet need for contraception in the first year postpartum is as high as 65%. Hence, this study aims to evaluate the safety and efficacy of immediate postpartum intrauterine contraceptive device (PPIUCD) as a method of contraception.
Methods: The study was undertaken in KIMS Hospital and Research Centre, Bangalore. A total of 60 patients were recruited following complete evaluation. 30 patients had immediate postpartum post placental insertion and 30 patients had intracesarean insertion of Cu T 380A.
Results: The patients who accepted PPIUCD mostly belonged to the age group 19-24 years, multigravida with one living issue. Insertion of IUCD was easy in 96.7% of the patients. Only 8.3% of the patients were anxious post insertion. 20% of the patients had minor complications, most commonly, bleeding and pain. There was only one case (1.7%) of infection (vaginitis). There were 23.3% of cases with missing strings but in all these cases IUCD was found in-situ on ultrasonography. Removal rate and expulsion rate were 6.7% and 5% respectively. Continuation rate was 88.3%.
Conclusions: We can conclude from this study, that immediate PPIUCD is an effective and inexpensive contraceptive for all delivered women, as it can be easily provided by trained midwives due to its ease of insertion, high continuation rate and no major complications. Thus, we can prevent unwanted pregnancies, abortions and its untoward effects.
Post-partum. IUCD reference manual. New Delhi: Family Planning Division, Ministry of Health and Family Welfare, Government of India; 2010.
Darroch JE, Sedgh G, Ball H, Contraceptive Technologies: Re-sponding to Women‟s Needs (New York: Guttmacher Institute; 2011.
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;136(3):432-35.
Goswami G. A Prospective Study to Evaluate Safety, Efficacy and Expulsion Rate of Post Placental Insertion of Intra Uterine Device. J Evol Med Dent Sci. 2015;4(56):9770-74.
Mishra S. Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra- Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD) J Obstet Gynaecol. India. 2014;64(5):337-43.
Jairaj S, Sridhar Dayyala. A Cross Sectional Study on Acceptability and Safety of IUCD among Postpartum Mothers at Tertiary Care Hospital, Telangana. J Clinic Diagnost Res. 2016;10(1):1-4.
Satyavathi. Post-partum intrauterine device insertion 2 yr experience at a tertiary care center in Guntur Medical College/Govt. General Hospital, Guntur. IOSR-JDMS. 2015;14(3):56-6.
Kittur S, Kabadi YM. Enhancing contraceptive usage by post-placental intrauterine con- traceptive devices (PPIUCD) insertion with evaluation of safety, efficacy, and expulsion. Int J Reprod Contracept Obstet Gynecol. 2012;1(1):26-32.
Celen S, Moroy P, Sucak A. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contracep. 2004;69:279-82.