Immediate post placental insertion of intrauterine contraceptive device at caesarean delivery: a prospective study

Authors

  • Sravani Mukka Department of Obstetrics and Gynecology, ESIC Medical College, Hyderabad, Telangana, India
  • Madhavi Y. Department of Obstetrics and Gynecology, ESIC Medical College, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202068

Keywords:

Copper T-380A, Intra-caesarean, Long acting reversible contraception, Post-partum Intrauterine contraceptive device

Abstract

Background: In India almost 65% of the women have an unmet need for family planning in the first postpartum year. Increasing rates of institutional deliveries creates an opportunity for providing quality post-partum family planning services. Post-partum Intrauterine contraceptive device (PPIUCD), a form of long acting reversible contraception (LARC) is one of the most affective and safest method available. The present study aims at evaluating the safety, efficacy, rate of acceptance and rate of discontinuation of Intra caesarean inserted contraceptive device Copper T-380A.

Methods: This was a prospective study conducted at ESIC Medical College, Sanathnagar in women delivered by caesarean section during the period between March 2018 to February 2019. Recruitment was done based on the WHO medical eligibility criteria (MEC) for PPIUCD and also their willingness to participate in the study. Follow-up visits were scheduled at 6 weeks, 3 months and 6 months.

Results: Of the 265 women fulfilling the WHO MEC, 180 (67.92%) were willing to participate in the study. Total acceptance rate was 67.7%. Majority of them belonged to the age group 21-30 years (80%) and para 2 (53.88). 93.3% of the women were literates. 12 (6.66%) cases lost to follow up and the complications were studied in the rest 168 women. During follow up -38.69% had missing strings, 12.5% menstrual disturbances, 4.76% abdominal pain and spontaneous expulsion in 4.1%. No cases of perforation and pregnancy were reported. Total continuation rate was 84%.

Conclusions: PPIUCD is a safe and convenient option of contraception with low expulsion rates and high continuation rates.

References

Population of India. 2017. Available at: https://www.indiaonline pages.com/population/india-current-population.html. Accessed on 21st February 2020.

Post-partum IUCD reference manual, family planning division. Ministry of Health and Family Welfare, Go vernment of India, New Delhi, India; 2010. Available at: http://www.nrhmtn.gov.in/ modules/PPIUCD%20Reference%20Manual.pdf. Accessed on 21st February 2020.

Huang YM, Merkatz R, Kang JZ, Roberts K, Hu XY, Di Donato F, et al. Postpartum unintended pregnancy and contraception practice among rural-to-urban migrant women in Shanghai. Contracept. 2012;86(6):731-8.

Rutstein SO, Macro OR. Fertility levels, trends, and differentials 1995-1999. Available at: https://agris.fao.org/agris-search/search.do?recordID =XF2015035876. Accessed on 21st February 2020.

Grimes DA, Lopez LM, Schulz KF, Van Vliet HA, Stanwood NL. Immediate post‐partum insertion of intrauterine devices. Cochrane Data Syst Rev. 2010(5):CD003036.

Grimes K, Schluz H, Van Vliet, N. Stanwood. Immediate Post-Partum insertion of intra uterine devices. Cochrane Data Syst Rev. 2003;CD00306.

Gupta D, Sharma S, Kanhere A, Jahan I. Study of acceptance of intra-cesarean IUCD as method of contraception. Int J Reprod Contracept Obstet Gynecol. 2017;6(11):5033-7.

Kanhere AV, Pateriya P, Jain M. Acceptability and feasibility of immediate post-partum IUCD insertion in a tertiary care in Central India. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):179-84.

Celen S, Moroy P, Sucak A. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contracept. 2004;69:279-82.

Katheit G, Agarwal J. Evaluation of post placental intra uterine device (PPIUCD) in terms of awareness, acceptance and expulsion in a tertiary care centre. Int J Reprod Contracept Obstet Gynecol. 2013;2:539-43.

Grimes D, Schluz K, Van Vliet H. Immediate post-partum insertion of intra uterine devices:a Cochrane review. Human Reprod. 2001;17(3):549-54.

Blanchard H, Mac Kiag C, ACCESS-FP Program. Post-partum contraception. 2006. Available at: http://www.k4health.org/sites/default/files/postpartumabortion_English.pdf. Accessed on 21st February 2020.

Gupta A, Verma A, 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.

Singals, Bharati R, Dewan R. Clinical outcome of post placental copper 380A insertion in women delivering by caesarean section. J Clin Diagn Res. 2014;8(9):OC04.

Patel J, Vyas R, Shah S, Parikh P. Evaluation of PPIUCD insertion as a method of contraception in India. IOSR-JDMS. 2017;16(6):49-53.

Hooda R, Mann S, Nanda S, Gupta A, More H, Bhutani J. Immediate postpartum intrauterine contraceptive device insertions in caesarean and vaginal deliveries: a comparative study of follow-up outcomes. Int J Reproduct Medi. 2016;2016.

Halder A, Sowmya MS, Gayen A, Bhattacharya P, Mukherjee S, Datta S, et al. A retrospective study to evaluate vaginal insertion and intra caesarean insertion of post-partum intra uterine contraceptive device. J Obstet Gynecol India. 2016;66(1):35-41.

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Published

2020-05-27

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Original Research Articles