Clinical outcome of post-abortion intrauterine contraceptive device insertion

Authors

  • Rupali Dewan Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India
  • Priyanka Rani Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20202298

Keywords:

Continuation, Immediate insertion, Intrauterine device, Post abortion contraception, Satisfaction

Abstract

Background: Clinical outcome of post abortion IUCD varies according to type of abortion, method of abortion and period of abortion. There is paucity of Indian literature regarding factor affecting clinical outcome of post-abortal intrauterine contraceptive device insertion. This study was conducted to evaluate clinical outcome of post abortion intrauterine contraceptive in terms of acceptability, safety and continuation rate.

Methods: A prospective cohort study where 112 patients over period of 18 months (November 2017 to April 2019) were included in study done at VMMC and Safdarjung Hospital, New Delhi, India.

Results: Total 112 patients recruited. Their age ranges from 26-30 years. Mean age of women were 28.11±4.51 years. Majority of women who underwent IUCD insertion were para2. Regardless of type of IUCD, the most common side effects associated with copper wearing IUCD were change in amount of menstrual flow. Two cases of PID after CuT380A insertion and one case of PID after cu375. No perforation occurred. Continuation rate were 86.79%. Satisfaction rate were 82.14%.

Conclusions: There is higher rate of continuation and satisfaction among women who had undergone immediate post abortion OUCD insertion. Early insertion of IUCD after abortion is safe, effective and well tolerated by women. Clinical outcome of post abortion is not affected by type of copper containing IUCD i.e., Cu380A and Cu375.

References

Behera D, Bharat S, Gawde NC. Induced abortion practices in an Urban Indian slum: exploring reasons, pathways and experiences. J Family Reprod Health. 2015;9(3):129-35.

Schreiber CA, Sober S, Ratcliffe S, Creinin M. Ovulation resumption after medical abortion with mifepristone and misoprostol. Contracept. 2015;84:230-3.

Gillett PG, Lee NH, Yuzpe AA, Cerskus I. A comparison of the efficacy and acceptability of the Copper-7 intrauterine device following immediate or delayed insertion after first-trimester therapeutic abortion. Fertil-Steril. 1980;34:121-4.

Bednarek PH, Creinin MD, Reeves MF. Post-aspiration IUD randomization (PAIR) study trial group. immediate versus delayed IUD insertion after uterine aspiration. N Eng J Med. 2011;364(23):2208-17.

World Health Organization Task Force on Intrauterine Devices for Fertility Regulation. IUD insertion following termination of pregnancy: a clinical trial of the TCu 220C, Lippes loop D, and copper 7. Stud Fam Plann. 1983;14:99-108.

Drey EA, Reeves MF, Ogawa DD, Sokoloff A, Darney PD, Steinauer JE Insertion of intrauterine contraceptives immediately following first- and second-trimester abortions. Contracept. 2009;79(5):397-402.

Shimoni N, Davis A, Ramos ME, Rosario L, Westhoff C. Timing of copper intrauterine device insertion after medical abortion. Obstet Gynecol. 2011;118:623-8.

Saav I, Stephansson O, Gemzell-Danielsson K. Early versus delayed insertion of intrauterine contraception after medical abortion: a randomized controlled trial. PloS One. 2012;7:e48948.

Dewan R, Nivedita, Mittal A, Dewan A. Early IUD insertion after medically induced abortion. Eu J Contracept Reprod Health Care. 2018;23:231-6.

Arowojolu AO, Otolorin EO, Ladipo OA. Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial. Afr J Med Sci. 1995;24:59-65.

Celen S. Immediate post-placental insertion of an intrauterine contraceptive device during cesarean section. Contracept. 2011;84(3):240-3.

Stanwood NL, Grimes DA, Schulz KF. Insertion of an intrauterine contraceptive device after induced or spontaneous abortion: a review of evidence. Br J Obstet Gynaecol. 2001;108:1168-73.

Pohjoranta E, Mentula M, Gissler M, Suhonen S, Heikinheimo O. Provision of intrauterine contraception in association with first trimester induced abortion reduces the need of repeat abortion: first- year results of a randomized controlled trial. Hum Reprod. 2015;30:2539-46.

Trussell J. Contraceptive failure in the United States. Contracept. 2004;70:89-96.

McNicholas C, Hotchkiss T, Madden T, Zhao Q, Allsworth J, Peipert JF. Immediate post-abortion intrauterine device insertion: continuation and satisfaction. Womens Health Issues. 2012;22(4):e365-e369.

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Published

2020-05-27

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Original Research Articles