Evaluation of clinical outcome of post placental insertion of Cu T 380 A in women undergoing caesarean delivery

Dineshwar Singh, Sita Thakur, Ajay Sood


Background: The objective of the study was to evaluate clinical outcome of insertion of post placental Cu T 380 A in women undergoing caesarean delivery.

Methods: A prospective observational study was carried out in the department of obstetrics and gynecology, Dr RPGMC Kangra at Tanda (Rural Medical College) to evaluate the clinical outcome of post placental Cu T 380 A insertion in women undergoing caesarean section after taking approval of protocol review and institutional ethics committee of the institution. A total of 104 women delivering by caesarean section and wanting post-placental intra-caesarean Cu T 380 A insertion and who were meeting WHO standard medical criteria for PPIUCD insertion and were willing to comply with the study protocol was recruited for the study.

Results: The present study showed that there were no major complications and only minor side effects were like pain, fever, discharge and irregular bleeding which were observed in only 5-15% of women during hospital stay and during follow up visit up to 6 months. String became visible in 72.12% of women at the 6 weeks follow up visit. The string visibility increased with time and at 6 months follow up stings became visible in 90.81% of the cases. Continuation rate was 100% at 6 weeks post-partum follow up. After that spontaneous expulsion occurred in 4 cases (3.84%) and another 4 women (3.84%) requested removal for various reasons leading to continuation rate of 92.3% at six months post-partum follow up. There was no case of pregnancy with Cu T in situ with no failure at the end of study at six months post-partum.

Conclusions: Intra caesarean insertion of PPIUCD is practical, convenient, safe, effective and acceptable contraceptive method for spacing of the birth in this rural setting.


Clinical outcomes, Continuation, Cu-T 380 A, Family planning, Intrauterine contraceptive device, Postpartum contraception

Full Text:



Family Planning Division Ministry of Health and Family Welfare. IUCD Reference Manual for Medical Officers and Nursing Personnel, Government of India; 2013.

Ross JA, Winfrey WL. Contraceptive use, intension to use and unmet needs during the extending postpartum period. Int Family Perspect. 2001;27:20-7.

VidyaRama R, Nagamani T, Prasad U. PPIUCD as a Long acting reversible contraceptive (LARC)-an experience at a tertiary care centre. Int J Sci Res. 2015;4(5):3-5.

Bhat P, Arnold F, Gupta K, Kishor S, Parasuraman S, Arokiasamy P, et al. International Institute for Population Sciences (IIPS) and Macro International, National Family Health Survey (NFHS-3). 2005-6; 2007:15-9

Upmanyu P, Kanhere A. Acceptance of methods of family planning in patients undergoing repeat caesarean section. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):976-9.

Singh S, Malik R, Ahalawat R, Taneja BK. Evaluation of efficacy, expulsion and safety of post-placental and intra-caesarean insertion of intrauterine contraceptive devices. Int J Reprod Contracept Obstet Gynecol. 2015;4(6):2005-9.

Safwat A, Ibrahim MA. Kamel OM. Shaaban. Hossam T. Salem. Acceptability for the use of postpartum intrauterine contraceptive devices: assiut experience. Med Princ Pract. 2003;12:170-5.

Garuda L, Kambham S, Ohita B. Clinical outcome of PPIUCD (Copper-380A) intra-caesarean insertion. Indian J Obstetr Gynaecol Res. 2015;2(4):218-26.

Bedi PK, Guliani MS, Bala S. A prospective study to assess the safety and expulsion rate of copper T 380A in immediate post-partum period during caesarean section. Int J Reprod Contracept Obstet Gynecol. 2016;5(9):3195-9.

Shanavas A, Jacob S, Chellamma N. Outcome of immediate postpartum intrauterine contraceptive device in caesarean versus vaginal insertion: a comparative study. Int J Reprod Contracept Obstet Gynecol. 2017;6(2):694-9.

Sharma A, Gupta V, Bansal N, Sharma U, Tandon A. A prospective study of immediate postpartum intra uterine device insertion in a tertiary level hospital. IJRMS. 2015;3(1):183-7.

Singal S, Bharti R, Dewan R, Divya, Dabral A, Batra A. Clinical outcome of postplacental copper T 380A insertion in women delivering by caesarean section. J Clin Diagn Res. 2014;8(9):OC01-04.

Arshad F, Ejaz L, Noreen H, Bano N, Syed S, Chaudhri R. Trans caesarean insertion of intrauterine contraceptive device. JSOGP. 2014;4(2):73-8.

Mishra N, Dalal N, Joshi V. Intrauterine device insertion during caesarean section - A boon for rural women. IOSR-JDMS. 2013;8(3):21-3.

Rahman LM, Banerjee A. A study on IUCD insertion during postpartum period (PPIUCD). J Evid Based Med. 2016;3(69):3768-70.

Zulficar BS, Javed BI, Khadeja B. Insertion of intrauterine contraceptive device at caesarean section. J Colg Phys Surg Pak. 2011;21(9):527- 30.

Nayak AK, Jain MK. Experience on awareness, acceptability, safety, efficacy, complications and expulsion of post-partum intrauterine contraceptive device insertion. IJSS. 2017;5(I):207-12.

Gupta A, Verma AR, Chauhan J. Evaluation of PPIUCD versus interval IUCD (380A) insertion in a teaching hospital of Western U. P. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):204-8.

Halder A, Sowmya MS, Gayen A, Bhattacharya P, Mukherjee S, Datta S. A prospective study to evaluate vaginal insertion and intra- caesarean insertion of post-partum intrauterine contraceptive device. Indian J Obstetr Gynaecol Res. 2016;66(1):35-41.

Ndegwa S, Qureyshi Z, Lubano K. The impact of two levels of counseling on acceptance, uptake, early outcomes of post placental IUCD. Univ Nairobi. Dept Obstetr Gynec; 2010.