Post-placental intrauterine device insertion--a five year experience at a tertiary care centre in north India (original) (raw)
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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...
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...
International Journal of Research in Medical Sciences, 2015
Background: In India there is an unmet need for contraception. Intrauterine device is a long acting reversible method. This study was done to determine the efficacy and safety of immediate Post-Partum Intrauterine Device (PPIUD) and to compare the outcome of PPIUD insertion after vaginal delivery and caesarean section. Methods: A total of 113 women who underwent PPIUD insertion were followed up at 6 weeks and 6 months postpartum. Outcome in term of side effects, removal and expulsion was compared in vaginal delivery and caesarean section insertions. Results: In 61.45% women there was no complaint. Menstrual disturbances were found in 16.66% women and pelvic pain in 13.54% women. The expulsion rate was 5.20% and IUD removal was done in 13.54% women. Incidence of removal was more in vaginal insertions than in caesarean insertions and this difference was statistically significant. Continuation rate at 6 months was 81.25%. Conclusion: Immediate postpartum IUD insertion is a safe, convenient and effective method.
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 ...
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.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2012
Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of placental expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.
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.
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.
International Journal of Clinical Obstetrics and Gynaecology, 2020
Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the WHO, as one of the safe and effective methods of temporary contraception. Hence; the present study was conducted for assessing the efficacy of post placental and intra-cesarean insertion of intrauterine contraceptive devices. Materials & methods: A total of 500 women were enrolled in the present study that delivered at community health centre, Lopoje, Amritsar and were counseled for PPIUCD. Post-placental insertion was done and CuT 375 A was used. All the procedures were commenced under the hands of skilled and experienced gynecologists. Regular follow-up was done. Presence of any complication was recorded. All the results were recorded in Microsoft excel sheet and were analyzed by SPSS software. Results: Mean age of the subjects was found to be 17.9 years. Desire of pregnancy within one to two years was found to be present in 7.2 percent of the patients. Reasons of acceptance were "No remembrance once inserted" in 32.8 percent of the cases, while it was due to safety reasons in 15.2 percent of the cases. Expulsion occurred within a week in 0.8 percent of the cases, while it occurred within one week to one month in 5.4 percent of the cases. Conclusion: Post placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD) has a high rate of acceptance and is associated with lower incidence of complications. Even though it has higher safety index, still awareness of PPIUCD is very low among general female population.
2015
The intrauterine device (IUD) is one of the most widely used contraceptive methods in the world. Immediate post placental IUD insertion is relatively more comfortable, safe, and does not interfere with breastfeeding. The aim of this study was to assess effect of post puerperal and immediate post placental insertion of intrauterine contraceptive devices after cesarean delivery on women's health. A descriptive studydesign was used in this study. Setting: post partum and outpatient clinic units at three different hospitals. Participants: A convenient sample of 440 postpartum women underwent cesarean delivery. 252 of them were found inserting IUD after puerperal period. While 188 of them were found inserting IUD immediately post-placental during caesarean delivery; they were recruited into immediate post placental group Method: Data were collected from March, 2013 till May, 2014. Post puerperal participants firstly were interviewed after insertion of IUD at the outpatient clinics. While, immediate post placental participants were firstly interviewed immediate post cesarean delivery at the postpartum units at the selected hospitals settings. Both groups' participants were followed at first, third and sixth month after IUD insertion. Physical and ultrasound also were performed during each follow up visit. Results: There was no significant difference between immediate post placental and post puerperal IUD insertion groups regarding their base line characteristics (p>0.05) at different time of follow up. There was a significant difference between both regarding backache , abdominal pain and pelvic infection..Conclusion: Immediate post placental caesarean IUD insertion is highly effective contraceptive methods without significantly increasing the risk of adverse effects. Nurses should have a role in counselling women regarding immediate post placental IUD insertion during their antenatal care visits.