DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162104

Post placental copper-T 380A insertion after normal vaginal delivery and cesarean section and its clinical outcome

Jyoti Malik, Ashima Das, Pinki Rai, Sibadatta Das

Abstract


Background: Post placental IUCD insertion refers to the insertion of IUD within 10 minutes of expulsion of placenta. Intra-cesarean section is insertion of IUD after removal of placenta before closure of uterine incision. The objective of this study was to study the efficacy, safety and effect on menstrual cycle, expulsion, continuation and failure rate of post-placental copper-T 380A after vaginal and cesarean birth over the period of 1 year in tertiary centre.

Methods: A total 150 women who opted for insertion of copper-T 380A within 10 minutes of expulsion of placenta whether delivered vaginally or by cesarean section, were enrolled in study. Women having past history of ectopic pregnancy or any genital tract infection or hemorrhagic disorders, uterine anomaly, chorioamnionitis, LPV>18 hours, unresolved PPH, Hb<8 g% were excluded from the study.

Results: No incidence of perforation, PID or failure of contraception was detected. Percentage of satisfaction among users after 6 weeks 91%, 3 months 92.9% and 6 months 95.6%.

Conclusions: Although there was high incidence of missing IUCD threads (due to coiling of thread), actual expulsion rate was far lesser. Removal rate due to menorrhagia, pain abdomen and vaginal discharge was low and 6 months continuation rate was considerably good.


Keywords


Kelly’s forceps, PPIUCD insertion, Expulsion, Perforation, Failure of contraception

Full Text:

PDF

References


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

Grimes DA, Lopez LM, Schulz KF, Van Vliet HAAM, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2003;(1): CD003036.

John Hopkins Programme for International Education in Obstetrics and Gynecology (JHPIEGO), USA, 2010. Available at http://web.jhu.edu/administration/provost/past_provosts.

Shukla M, Qureshi S, Chandravati. Post-plecental intrauterine device insertion - a five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136:432-5.

Thiery M, Van Kets H, Van Der Pas H. Immediate postplacental IUD insertion: the expulsion problems. Contraception. 1985;31:331-49.

Muthal-Rathore A. Immediate postpartum insertion for intrauterine devices: RHL commentary. The WHO Reproductive Health Library. Geneva WHO 2010. Available at http://apps.who.int/rhl/archives/cd003036_muthalrathorea_com/en/index.html#.

Medical eligibility criteria for contraceptive use. 4th ed. Department of Reproductive Health, WHO; 2009. Available at http://apps.who.int/iris/bitstream/ 10665/181468/1/9789241549158_eng.pdf.

Welkovic S, Costa LO, Faundes A, de Alentar Ximenes R, Costa CF. Post-partum bleeding and infection after post-placental IUD insertion. Contraception. 2001;63:155-8.

Zhou SW, Chi IC. Immediate postpartum IUD insertions in a Chinese hospital: a two year follow-up. Int J Gynaecol Obstet. 1991;35:157-64.