Evaluation of efficacy, expulsion and safety of post-placental and intra-cesarean insertion of intrauterine contraceptive devices
Keywords:Intrauterine device, Postpartum contraception, PPIUCD
Background: The objective of the study was to evaluate the safety and efficacy of immediate postpartum intrauterine contraceptive device (PPIUCD) insertion in women delivering vaginally or by cesarean section.
Methods: This prospective study was carried out at General Hospital [Tertiary care] from August 2014 to September 2015. All antenatal patients admitted for delivery to our hospital were counseled for PPIUCD. Also consent was taken from those who opted for PPIUCD insertion.
Results: A total of 2016 women were counseled for PPIUCD adoption. Out of this, 1312 women accepted this method. Total number of deliveries during the study period was 2835. Total acceptance rate was 46.27%. The expulsion rate was 10.63% while removal rate was 7.74%. Out of 555 women who came for follow up, 453 women continued PPIUCD. Thus, continuation rate was 81.62%.
Conclusions: PPIUCD is easily accessible, reversible and cost effective contraceptive method for most postpartum women specially lactating women.
Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, InnisJ. Family planning: the unfinished agenda. Lancet. 2006;368:1810-827.
Xu JX, Reusche C, Burdan A. Immediate postplacental insertion of intrauterine device: A review of Chinese and world experiences. Adv Contracept. 1994;10:71-82.
World Health Organization: Medical Eligibility Criteria for Contraceptive Use. 4th ed. Geneva: World Health Organization. 2010:3-4.
International Institute for Population Sciences (IIPS) and Macro International, 2007. National Family Health Survey (NFHS-3). 2005–06;15-9.
Shukla M, Qureshi S, Chandrawati. Post placental intrauterine device insertion- A five yearexperienceat a tertiary care centre in north India. Indian J Med Res. 2012;136:432-5.
ChI-C, Farr G. Postpartum IUD contraception- a review of an international experience. Adv Contracept. 1989;5:127.
Alvarez pelayo J, B orbolla Sala ME. IUD Insertion during caesarean section and its most frequent complication. Ginecol Obstet Mex. 1994;62:330-5.
Safwat A, Mohamed Momen A, Kamel Omar M. Acceptability for the use of postpartum intrauterine contraceptive devices: assiut experience. Med Princ Pract. 2003;12:170-5.
Grimes D, Schulz K, van Vliet H, et al. Immediate post-partum insertion of intrauterine devices: a cochrane review. Hum Reprod. 2002;17(3):549-54.
Xu JX, rivera R, Dunson Tr, Zhuang LQ, Yang XL, Ma GT, Chi IC. Shanghai municipal family planning commission, People’s Republic of china. A comparative study of two techniques used in immediate postplacental insertion of copper T-380 A IUD in shanghai, people’s republic of china. Contraception. 1996;54(1):33-8.
Celen S, Moroy P, Sucak A. Clinical outcomes of early post placental insertion of intrauterine contraceptive devices. Contraception. 2004;69:279-82.
El-shafei MM, Mashali A, Hassan EO, El Boghdadi L, El Lakkany N. Post partum and post abortion intra uterine device insertion unmet needs of safe reproductive health: 3 years’ experience of a Mansoura university hospital. Egypt Soc Obstet Gynaecol. 2000;26:253-62.
Lara RR, Tobias GM, Parez CR, Ramirez NV. Estudiocomparativo al azar entre los dispositivos intrauterinos Multiload Cu375 y TCu 380A colocados durante ei postparto. Ginecol Obstet Mex. 2006;74:306-11.
Diaz S, Zepeda A, Maturana X, Reyes MV, Miranda P, Casado ME. Fertility regulation in nursing women. IX. Contraceptive performance, duration of lactation, infant growth, and bleeding patterns during use of progesterone vaginal rings, progestin-only pills, Norplant implants, and Copper T 380-A intrauterine devices. Contraception. 1997;56:223-32.
Tatum HJ, Beltran RS, Ramos R, Van Kets H, Sivin I, Schmidt FH. Immediate postplacental insertion of GYNE-T380 and GYNE-T380 postpartum intrauterine contraceptive device. Am J Obstet Gynecol. 1996;175(5):1231-5.
Chi IC, Wilkens L, Roger S. Expulsions in immediate postpartum insertion of Lippes Loop D and Copper T IUD’s and their counterpart Delta devices-an epidemiological analysis. Contraception. 1985;32:119-34.