DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20211501

Analysis of postpartum intrauterine contraceptive devices

Sandhya A. Shrigadhi, Prabhakar S. Gawandi

Abstract


Background: PPIUCDs are the only postpartum family planning  method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum in lactating women. The public health benefits from PPIUCDs stemmed from the women’s increased accessibility to PPIUCDs following facility births, as PPIUCDs could be offered at health facilities after childbirth. It is an attempt to reduce unmet family planning need. The specific aims of this study were to assess the acceptability, feasibility expulsion rate and complications of PPIUCD insertion among women delivering at term in our institute who were eligible and counselled for PPIUCD.

Methods: Prospective study undertaken at Dr. Vaishampayan memorial government medical college, Solapur, Maharashtra conducted from September 2015 to August 2017. All women undergoing delivery at term in this institute and not having any contraindications for postpartum IUCD insertion were counseled for PPIUCD.

Results: A total 3032 were eligible for PPIUCD insertion and were counseled for the same. 1.97% women accepted PPIUCD insertion while 98.03% of them declined insertion. 1124 underwent caesarean section while 1908 had vaginal delivery. Among vaginal delivery group rate of acceptance was 1.20% while that in caesarean section group was 3.29%.

Conclusions: The present study concluded that overall acceptance of PPIUCD in our institute is 1.97 %. Considering fear of complications related to IUCD and partner refusal as major causes of refusal for PPIUCD in our study, emphasis on this aspect during counseling can improve acceptance.


Keywords


PPIUCD, Acceptability, Expulsion, Complications, Copper T 380 A

Full Text:

PDF

References


World Health Organization. Medical Eligibility Criteria for Contraceptive Use. Geneva World Health Organization, 2010.

Bhat PNM, Arnold F, Gupta K, Kishor S, Parasuraman S, Arokiasamy P, et al. India: National Family Health Survey (NFHS-3). Int Inst Populat Sci Macro Int. 2007;1.

India. Postpartum IUCD reference manual: Family Planning Division, Ministry of Health and Family Welfare, Government of India; New Delhi 2010.

Stoddard A, McNicholas C, Peipert JF. Efficacy and safety of long-acting reversible contraception. Drugs. 2011;71(8):969-80.

Kittur S, Kabadi YM. Enhancing contraceptive usage by post-placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy and expulsion. Int J Reprod Contracept Obstet Gynecol. 2012;1:26-32.

Grimes DA, Lopez LM, Schulz KF, Van-Vliet HA, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2010;(5):003036.

Gautam R, Arya KN, Kharakwal S, Singh S, Trivedi M. overview of immediate PPIUCD application in Bundelkhand Region. J Evol Med Dental Sci. 2014;3(36):9518-26.

Aswathy S, Jacob S, Nirmala C. 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.

Sujnanendra M. 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.

Mohamed SA, Kamel MA, Shaaban OM, Salem HT. Acceptability for the use of postpartum intrauterine contraceptive devices. Med Principle Pract. 2003;12:170-5.

Araujo VB, Ortiz L, Smith J. Postpartum IUD in Paraguay: a case Series of 3000 cases. Contraception. 2012;86:173-86.

Kumar S, Sethi R, Balasubramaniam S, Charurat E, Lalchandani K, Semba R, et al. Women’s experience with postpartum intrauterine contraceptive device use in India. Reproductive Health. 2014;11:32.

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80(4):327-36.

El-Shafei MM, Mashali A, Hassan EO, El-Boghdadi L, El-Lakkany N. Postpartum and postabortion intrauterine device insertion unmet needs of safe reproductive health: three years experience of a Mansoura university hospital. Egypt Society Obstet Gynecol. 2000;26:253-62.

Lara R, Sánchez RA, Aznar R. Application of intrauterine device through the incision of the cesarean section. Ginecol Obstet Mex. 1989;57:23-7.

Ricalde RL, Tobías GM, Pérez CR, Ramírez NV. Random comparative study between intrauterine device Multiload Cu375 and Tcu 380a inserted in the postpartum period. Ginecol Obstet Mex. 2006;74(6):306-11.