A prospective study of immediate postpartum intra uterine device insertion in a tertiary level hospital (original) (raw)

A prospective study of safety, efficacy and acceptability of postpartum insertion of intrauterine contraceptive device in a tertiary care hospital in Maharashtra, India

International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Background: IUCD (intrauterine contraceptive device) to prevent pregnancy are among the oldest method of contraception. The modern IUCD are highly effective, safe private, long acting and rapidly reversible contraceptive method. Aims and objective of this study was to study the acceptability and safety of postpartum intrauterine contraceptive device (PPIUCD) in postpartum period and to assess the feasibility, safety, efficacy and expulsion rate of IUCD.Methods: A prospective observational study was conducted at tertiary care teaching hospital in Maharashtra from January 2018 to October 2018 and patients were followed up to a period of one-year post IUCD insertion.Results: Majority of patients in this study were in age group 21 to 26 years of age (58.7%) and the least number were in the age group more than 30 years (3.3%). This study showed that majority of patients were primigravida (44%) and the lowest number belonged to gravida 6 (0.3%). Regarding timing of IUCD insertion 73% were...

Efficacy and safety of Post-Partum Intrauterine Contraceptive device (PPIUCD) insertion-A prospective study

IP Innovative Publication Pvt.Ltd, 2017

Introduction: Significantly increased institutional deliveries in India provide an opportune time for offering postpartum family planning services to the women. Although the available contraceptive methods are many, need of a single efficacious, feasible and cost effective method is desirable especially in a low resource country like India. This study was done to evaluate the acceptance, efficacy and safety of intrauterine contraceptive device as an immediate family planning method following delivery, and the complications associated with it. Materials and Method: A total of 115 women who underwent PPIUCD insertion were followed up at 1, 3 & 6 weeks and at 3 & 6 months post-partum. Outcome in terms of side effects, removal and expulsion was noted and compared in vaginal delivery and caesarean section insertions. Results: Out of 280 women who were counselled, only 115 women (41.07%) accepted the PPIUCD insertion. Insertion in literate women was high and extremely statistically significant (P<0.0001) as compared to illiterate women. Expulsion rate was 17.85%. There was no expulsion in intracaesarean PPIUCD insertion which is statistically significant (P < 0.01) as compared to postplacental insertion. Excessive discharge (26.09%), missing strings (5.22%) and menorrhagia (4.35%) were minor complications.3 women (2.61%) had failure of PPIUCD at 6 months follow up. Conclusion: PPIUCD is a safe and efficacious family planning method after vaginal as well as caesarean delivery.

Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD)

Journal of obstetrics and gynaecology of India, 2014

This study examines to describe the factors associated with acceptability of immediate PPIUCD insertion in women according to their socio-demographic and obstetrics characteristics, and future pregnancy desires and to determine the rates of uterine perforation, expulsion, pelvic infection, lost strings and displacement following PPIUCD insertion among the acceptors by 6 to 18 months. An intrauterine device (IUD) is an effective form of Long Acting Reversible Contraception. Present study is aimed at determining the safety, efficacy, and expulsion of Post-placental and intra-cesarean insertion of Intrauterine contraceptive device (PPIUCD). The study was conducted at District Head Quarters Hospital, Bolangir, Odisha, India. From 1st. January 2012 to 31st. December 2012. Women admitted and delivered at D.H.H. Bolangir, were counseled. CuT 380A was inserted within 10 minutes of delivery of placenta in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications f...

Outcome of immediate postpartum intrauterine contraceptive device in caesarean versus vaginal insertion: a comparative study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Background: Immediate Postpartum Intrauterine Contraceptive device is a novel approach to contraception which integrates Maternal - Child health and family planning services. It is a postpartum method which provides long term reversible contraception to women before discharge from the delivery setting. More research is needed in the field of PPIUCD to enhance awareness and acceptance in the community. This study is designed to compare the safety and efficacy of PPIUCD inserted at cesarean versus vaginal delivery.Methods: This is a prospective study conducted at Sree Avittom Thirunal Hospital, Govt. Medical College, and Kerala – A tertiary care teaching institution. A total of 126 patients with cesarean or vaginal deliveries had PPIUCD insertions and they were followed up for a period of one year. The outcome measures analyzed were safety measures – menstrual irregularities, vaginal discharge, pelvic infection and perforation and efficacy measures - failure, expulsion and removal. Da...

A randomized study for two techniques of immediate post-partum intrauterine contraceptive device insertion in India

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2014

Background: Postpartum women are susceptible for unintended pregnancy in the first postpartum year. They should be counselled by cafeteria approach and those who opt for Postpartum Intrauterine Contraceptive Device (PPIUCD), it should be inserted in the same sitting. Aims of current study were to compare 1) The technical feasibility in terms of client discomfort, immediate expulsion, perforation and time taken in insertion of the two insertion techniques, Manually vs Kelly's placental forceps. 2) The complications of the two techniques of insertion. 3) The expulsion rates at 1, 3 and 6 months. Methods: This was a randomized study in which 150 women were recruited. Group A had 75 subjects and insertion of PPIUCD was done manually. Group B had 75 subjects and insertion was done with Kelly's placental forceps. Results: There was no statistically significant difference in the mild discomfort during insertion by either technique. Time taken for insertion was significantly lower in group A. The combined expulsion rate (spontaneous complete expulsion and partial expulsion) at the end of 6 months was 11.9% in group A and 10.5% in group B (not statistically significant). Pain (16% in group A and 12% in group B) was the most common problem encountered by IUD users followed by menstrual problems (10.7% in group A and 8% in group B). There was no significant difference in the complication rate for the two groups (P >0.05). Conclusions: Manual technique of insertion of PPIUCD is equally good as compared to Kelly's placental forceps and it has no economic implications for purchasing and maintenance.

Post-placental intrauterine device insertion--a five year experience at a tertiary care centre in north India

PubMed, 2012

Background & objectives: In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective, long-term contraception such as intrauterine device (IUD) in post-partum women. The present study was planned to evaluate the safety and efficacy of immediate post-partum IUD insertion in women delivering vaginally or by caesarian section in a tertiary care centre facility in north India during a period of five years. Methods: The women recruited had CuT 200B insertion immediately after delivery of placenta in vaginal or caesarean delivery. Women having post-partum haemorrhage (PPH), anaemia, pre-labour rupture of membranes >18 h, obstructed labour and distorted uterine cavity by fibroid or by congenital malformation were excluded from the study. The women were followed up at 6 wk and 6 months after delivery. Results: A total of 1317 women were included in the study. Of these, 1037 (78.7%) came for first follow up. The cumulative expulsion rate at the end of 6 months was 10.68 per cent. There was no case of misplaced IUD. Interpretation & conclusions: Although the expulsion rate for immediate post-partum insertion was higher than for interval insertion, the benefits of providing highly effective contraception immediately after delivery outweigh this disadvantage, particularly in country where women have limited access to medical care.

A Prospective Study to Evaluate Vaginal Insertion and Intra-Cesarean Insertion of Post-Partum Intrauterine Contraceptive Device

The Journal of Obstetrics and Gynecology of India, 2014

Objectives Evaluation and comparison of safety and efficacy of vaginal and intra-cesarean insertion of Post-Partum Intrauterine Contraceptive device (PPIUCD). Methods An interventional prospective study conducted in the Department of Obstetrics and Gynaecology at NRS Medical College, Kolkata. PPIUCD were inserted in 263 mothers in 1-year study period. Among them, first 100 mothers who delivered vaginally and the first 100 who underwent cesarean section were regarded as study groups and were followed up for 1 year. Results Both modes of PPIUCD insertion were found to have very low rates of expulsion, vaginal bleeding, infection, missing strings, and also effective as contraceptive. Expulsion rate was 4 % in the vaginal group and 2 % in intra-cesarean group. Strings of PPIUCD were less visible after cesarean insertion than vaginal insertion (p = 0.028). Conclusion PPIUCD is an appealing approach and may become the best choice as post-partum contraception after vaginal as well as cesarean delivery. Keywords PPIUCD Á Vaginal insertion-post-placental Á Immediate post-partum Á Intra-cesarean insertion Halder A.

Women's experience with postpartum intrauterine contraceptive device use in India

Reproductive Health, 2014

Background: Postpartum intrauterine contraceptive devices (PPIUCD) are increasingly included in many national postpartum family planning (PPFP) programs, but satisfaction of women who have adopted PPIUCD and complication rates need further characterization. Our specific aims were to describe women who accepted PPIUCD, their experience and satisfaction with their choice, and complication of expulsion or infection. Methods: We studied 2,733 married women, aged 15-49 years, who received PPIUCD in sixteen health facilities, located in eight states and the national capital territory of India, at the time of IUCD insertion and six weeks later. The satisfaction of women who received IUCD during the postpartum period and problems and complications following insertion were assessed using standardized questionnaires. Results: Mean (SD) age of women accepting PPIUCD was 24 (4) years. Over half of women had parity of one, and nearly one-quarter had no formal schooling. Nearly all women (99.6%) reported that they were satisfied with IUCD at the time of insertion and 92% reported satisfaction at the six-week follow-up visit. The rate of expulsion of IUCD was 3.6% by six weeks of follow-up. There were large variations in rates of problems and complications that were largely attributable to the individual hospitals implementing the study. Conclusions: Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.

A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no ...

Status of Postpartum Intra Uterine Contraceptive Device in a Tertiary Care Hospital in Dhaka

Journal of National Institute of Neurosciences Bangladesh, 2022

Background: Timing of insertion, counseling, provider training and institutional support are critical factors for intrauterine contraceptive devices (IUCD) use during the postpartum period. Objective: The objective of the study was to determine the rate of acceptation, discontinuation, expulsion, infection and displacement of PPIUCD after vaginal delivery and cesarean section along with other complications among the study population. Methodology: This was a prospective observational study done in Shaheed Suhrawardy Medical College and Hospital from July 2015 to June 2016 among the pregnant women who delivered healthy baby by normal vaginal delivery and cesarean section. Data was collected by a structured questionnaire. Women who gave informed consent and who gave birth of healthy baby without complications were included. Women who had premature ruptured membrane with chorioamnionitis, pelvic inflammatory disease intrauterine fetal death or who did not give consent were excluded. Res...