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


  • Dineshwar Singh Department of Obstetrics and Gynecology, Dr RPGMC Kangra at Tanda, Himachal Pradesh, India
  • Sita Thakur Department of Obstetrics and Gynecology, Dr RPGMC Kangra at Tanda, Himachal Pradesh, India
  • Ajay Sood Department of Obstetrics and Gynecology, Dr RPGMC Kangra at Tanda, Himachal Pradesh, India




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


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.


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.






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