DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20163407
Published: 2016-12-15

Immediate postpartum insertion of intrauterine devices: experience of maternity ward of the university and teaching hospital of Treichville, Abidjan

Privat Yere Guie, Jean Marc Hervé Lamine Dia, Gérard Okon, Telly SY

Abstract


Background: In Côte d’Ivoire, where the rate of undesired pregnancies is high, we were the first Maternity centre, to benefit from training on immediate postpartum insertion of intrauterine devices (IUD).  The objective of this study is to share our experience and present the results of this practice in our hospital.

Methods: It was a prospective and descriptive cohort study from the 11th of November 2013 to the 30th of April 2016 including the patients who delivered at the maternity of CHU Treichville (University Hospital Centre, Abidjan, Côte d’Ivoire), and had immediate postpartum IUD insertion, with a control 6 weeks later and then 3 months later.

Results: 790 IUD have been, inserted to women with average age and gravidity of respectively 31.3 years old (13-52 years) and 4.4 (1-12 pregnancies). Most of our patients had a low socioeconomic status (poor education: 51.1%; not married: 59.9%). The counseling occurred during the latent phase of the labour for 57.2% of the women and the major parts of the IUD (59, 1%) were insert during a caesarean section. We noticed a poor rate of default patients (14 lost after 3 months), no complications but 9% of side effects (spontaneous expulsion, missing string). During the follow up period, four patients decided to remove the device. One of them for pelvic pain and three for a non-motivated request of the patients.

Conclusions: Our experience shows that on immediate postpartum insertion of IUD is possible in our environment.


Keywords


Contraception, Postpartum, IUD

Full Text:

PDF

References


Rathore AM. Immediate postpartum insertion for intrauterine devices. The WHO Reproductive Health Library ; Geneva : World Health Organization; 2010.

Grimes D, Schlz K, Vliet Van H, Stanwood N. Immediate post-partum insertion of intrauterine devices: a cochrane review. Human Reproduction. 2002;17:549-54.

Tatum HJ, Beltran RS, Ramos R, Van Kets H, Sivin I, Schmidt FH. Immediate post placental insertion of GYNE-T 380 and GYNE-T 380 postpartum intrauterine contraceptive devices: randomized study. Am J Obstet Gynecol. 1996;175(5):1231-5.

Cwiak C, Gellasch T, Zieman M. Peripartum contraceptive attitudes and practices. Contraception. 2004;70:383-6.

Thiery M, Van Kets H, Van der Pas H. Immediate post-placental IUD insertion: the expulsion problem. Contraception. 1985;31(4):331-49.

Vroh JB, Tiembre I, Attoh-Toure H, Kouadio D E, Kouakou L, Coulibaly L, et al. Épidémiologie des avortements provoqués en Côte d'Ivoire. In Santé Publique HS. 2012;24:67-76.

Doumbia Y, Djanhan Y, Kouakou K. Problématique des décès maternels par hémorragie à la maternité de formation sanitaire d'Abobo Sud (ABIDJAN). Rev Int de Sci Méd. 2006;8(2):41-5.

Ujah IAO, Aisien OA, Mutihir JT, Vanderjagt DJ, Glew RH, Uguru VE. Factors contributing to maternal mortality in North-Central Nigeria: a seventeen-year review. African Journal of Reproductive Health. 2005;9(3):27-40.

Desgrées Du Loû A, Msellati P, Viho I, Welffens-Ekra C. Le recours à l'avortement provoqué à Abidjan: une cause de la baisse de la fécondité? In Population. 1999;54(3):427-46.

Mayi-Tsonga S, Obiang PA, Minkobame U, Ngouafo D, Ambounda N, de Souza MH. Introduction of postabortion contraception, prioritizing long-acting reversible contraceptives, in the principal maternity hospital of Gabon. Int J Gynecol Obstet. 2014;126(Suppl 1):45-8.

Gonzalez JS, Lunde BM, Stimel S, Fishman DA, Thomas AG. Ultrasound surveillance of intrauterine devices placed immediately after cesarean delivery. Obstet Gynecol. 2015;125 Suppl 1:67S.

O’Hanley K, Huber DH. Postpartum IUDS: key for success. Contraception. 1992;45(4):351-61.

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices. J Obstet Gynaecol India. 2014;64(5):337-43.

Lester F, Kakaire O, Byamugisha J, Averbach S, Fortin J, Maurer R, et al. Intra-cesarean insertion of the Copper T 380 A versus 6 weeks post-cesarean: a randomized clinical trial. Contraception. 2014;91(3):198-203.

Washington CI, Jamshidi R, Thung SF, Nayeri UA, Caughey AB, Werner EF. Timing of post-partum intra-uterine device placement: a cost-effectiveness analysis. Fertil Steril. 2015;103(1):131-7.

CHI IC, Wilkens L, Rogers S. Expulsion in immediate postpartum insertion of lippes loop D and Copper T IUD’s and their counterpart delta devices, an epidemiological analysis. Contraception. 1995;32:119-34.