A retrospective analysis on acceptability and complications of PPIUCD insertion
Keywords:Contraception, Post-Partum, PPIUCD
Background: In India, 65% of women in the first year postpartum have an unmet need for family planning but only 26% of women are using any method of family planning during the first year postpartum. This leaves a huge gap which needs to be addressed if maternal health is to be optimized. This calls for a method which is both effective and acceptable immediately post-partum. This is where the role of PPIUCD needs to be studied.
Methods: This study was a retrospective observational study conducted in a tertiary care hospital. All deliveries during the time period from September 2016 to August 2017 were included in the study and the women accepting PPIUCD were studied for analysed for their age, parity, booking status and complaints during the follow up visit.
Results: A total of 13,039 deliveries took place in one year between Sept 2016 to Aug 2017 out of which, 1118 (8.6%) accepted PPIUCD as a method of contraception. 44.3% PPIUCD users were in the age group of 21-25 years. 57% of PPIUCD users were primigravidas. 84% of PPIUCD users were booked cases. Missing threads was the most common complication, with 8.4% patients reporting it at follow up. There were no major complications noted in the study.
Conclusions: PPIUCD is a safe and effective long acting reversible contraception method. Is particularly beneficial in a setting where women do not return for contraceptive advice. With low expulsion rates and high continuation rate, authors can conclude that PPIUCD can be the solution to a country like India currently facing population crisis and high unmet need.
Sharma A, Gupta V. A study of awareness and factors affecting acceptance of PPIUCD in South-East Rajasthan. Int J Community Med Public Health. 2017;4:2706-10.
Nayak AK, Jain MK. Experience on awareness, acceptability, safety, efficacy, complications and expulsion of post-partum intrauterine contraceptive device insertion. Int J Sci Stud. 2017;5(1):207-12.
Doley R, Pegu B. A retrospective study on acceptability and complications of PPIUCD insertion. J Evol Med Dent Sci. 2016;5(31):1631-4.
Chauhan R, Sahni S, Hanumantaiya S. Evaluation of acceptability, safety and expulsion rate of PPIUCD. Int J Reprod Contracept Obstet Gynecol. 2018;7:1083-9.
Medical eligibility criteria for contraceptive use, Fifth edition 2015. Available at: http://apps.who.int/iris/bitstream/10665/181468/1/97 89241549158_eng.pdf.
Mohamed SA, Kamel MA, Shaaban OM, Salem HT. Acceptability for the use of postpartum intrauterine contraceptive devices: Assiut experience. Med Princip Pract. 2003;12(3):170-5.
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.
Kanhere A, Pateriya P, Jain M. Acceptability and Feasibility of Immediate post-partum IUCD insertion in a tertiary care centre in Central India. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):179-84.
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.
Sudha CP, Priyanka HK, Nagaiah D. A study to evaluate safety and efficacy of immediate postpartum postplacental IUCD insertion. Int J Reprod Contracept Obstet Gynecol. 2017;6(6):2284-8.