Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

Authors

  • Rekha Jain Department of Obstetrics and Gynecology, Hindu Rao Hospital and NDMC Medical College, Malkaganj, Delhi, India
  • Manisha Sharma Department of Obstetrics and Gynecology, Hindu Rao Hospital and NDMC Medical College, Malkaganj, Delhi, India
  • Shruti Gupta Department of Obstetrics and Gynecology, Hindu Rao Hospital and NDMC Medical College, Malkaganj, Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20191942

Keywords:

Intra uterine contraceptive device, PPIUCD, CuT 380 A, CuT 375

Abstract

Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery.  This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.

Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.

Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.

Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel.

References

IUD guidelines for family planning service programme by Piiego JH. USAID; 2006.

Singal S, Bharti R, Dewan R. Clinical outcome of post placental copper T 380 A insertion in women delivering by caesarean section. J Clin Diagn Res. 2014;8(9):04.

Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period international family planning perspectives. Int Fam Plann Persp. 2001;27(1):20-7.

Vernon R. Meeting the family planning needs of postpartum women. Studd Fam Plann. 2009;40(3):235-45.

Grimes D, Schultz K, van Vliet Hand. Immediate post-partum insertion of intrauterine devices. A Cochrane review. Hum Repro. 2002;17(3):549-6.

Safawat A, Mohamed MA, Kamel Omar M. Acceptability for the use of postpartum intrauterine devices. Med Princ Pract. 2003;12:170-7.

Mishra S. Evaluation of safety, efficacy, and expulsion of PPIUCD. J Obs Gynae India. 2014;64(5):337-43.

Ahuja R, Rathore A. Continuation rates of postpartum intrauterine device (IUCD) insertion: randomized trial of post placental versus immediate postpartum insertion. BJOG Int J Obstet Gynaecol. 2014;121(2):9-117.

Katheit G, Aggarwal J. Evaluation of post placental intrauterine device (PPIUCD) in terms of awareness, acceptance and expulsion in a tertiary care center. Int J Reprod Contraceptive Obstet Gynaecol. 2013;2(4):539-43.

Khader YS, EL Quaderi S, Khader M. Intrauterine contraceptive device discontinuation among Jordanian women rate, causes and determinants. J Fam Plan Repro Health Care. 2006;32(3):16.

Mahdy N, EL Zeiny N. Probability of contraceptive continuation and its determinants. East Meditrr Health J. 1999;5:26-39.

Sharma M. Intra uterine contraceptive device discontinuation. The J Obst Gynaecol India. 2014;64(3):208-11.

Downloads

Published

2019-04-29

Issue

Section

Original Research Articles