A comparative clinical study between intra-caesarean and interval intra uterine copper device insertion in caesarean deliveries

Authors

  • Geetha Lakshmi R. Department of Obstetrics and Gynecology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
  • Sornam M. S. Department of Obstetrics and Gynecology, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
  • Thenmozhi G. Department of Obstetrics and Gynecology, Chengalpattu Medical College and Hospital, Chengalpattu, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20194170

Keywords:

Caesarean delivery, Intra-caesarean, Interval, IUCD, Postpartum

Abstract

Background: Health and family welfare of Indian Ministry, emphasis on postpartum IUCD insertion. Here we conducted a clinical study comparing intra-caesarean and interval CuT-380A insertion in caesarean deliveries.

Methods: A systematic study with 150 patients in each group, recruited clients alternately. Group A Intra-Caesarean Cu-T insertion and Group B Interval Cu-T insertion in caesarean deliveries. Groups were followed up at 6th week and 6th month post insertion with a set of parameters. Missed strings, expulsion and infection rates were the primary outcome measures.

Results: Infection rate is higher in Group A (2.3%) at 6th week, and at 6th month infection rate is higher in Group B (1.8%). Missed strings are higher in intra-caesarean than in interval insertion method both at 6th week and 6th month follow up p=0.000, hence significant. Expulsion rate is higher in Group A (2.5%) at 6th week, and at 6th month expulsion rate is higher in Group B (1.9%). There are no complications such as uterine perforation or contraceptive failures in both the groups during the study period. By analysis, there are no significant differences in infection and expulsion rates between the groups. For missed strings there is significant difference between the groups with more missed strings in intra-caesarean insertion method.

Conclusions: To conclude, intra-caesarean method is equally effective as interval IUCD insertion method without added complications in caesarean deliveries, with advantage of high motivation, good compliance, safety and ease for the provider to deliver services.

 

References

Reference manual, post-partum IUCD, family planning division, Ministry of Health and Family Welfare, Government of India, Nirman Bhawan, New Delhi; 2010. Available at: http://www.nrhmtn.gov.in/modules/PPIUCD%20Reference%20Manual.pdf.

Reference manual, counseling for post-partum family planning and post-partum IUCD, family planning division, Ministry of Health and Family Welfare, Government of India, Nirman Bhawan, New Delhi; 2012. Available at: http://www.nrhmtn.gov.in/modules/PPFP%20&%20PPIUCD%20Counseling%20Ref%20Manual%20-%20English.pdf.

Letti Müller AL, Lopes Ramos JG, Martins-Costa SH. Transvaginal ultra-sonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study. Contra. 2005;72(3):192-5.

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum. Contra. 2009;80:327-36.

Nelson A, Chen S, Eden R. Intraoperative placement of the Copper T-380 intrauterine devices in women undergoing elective caesarean delivery: a pilot study. Contra. 2009;80(1):81-3.

Celen S, Sucak A, Yildez Y, Danisman N. Immediate post placental insertion of an intrauterine contraceptive device during cesarean section. Contra. 2011;84(3):240-3.

Levi E, Cantillo E, Ades V, Banks E, Murthy A. Immediate post placental IUD insertion at caesarean delivery: a prospective cohort study. Contra. 2012;86(2):102-5.

Singal S, Bharti R, Dewan R. Clinical outcome of post placental Copper T 380A insertion in women delivering by caesarean section. J Clin Diagn Res. 2014;8(9):OC01-OC04.

Lester F, Kakaire O, Byamugisha J. Intracaesarean insertion of the Copper T380A versus 6 weeks post caesarean: a randomized clinical trial. Contra. 2015;91(3):198-203.

Goldstuck ND, Steyn PS. Insertion of intrauterine devices after cesarean section: a systematic review update. Int J Women’s Health. 2017;9:205-12.

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Published

2019-09-26

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Original Research Articles