Long Term Evaluation of Post-Partum Intrauterine Device (PPIUD) In Terms of Safety and Efficacy (original) (raw)
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International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
India is the second most populous country in the world, sustaining 17.01% of world population on 2.4% of world's surface area. According to Census 2011 the population of India on 1 March 2011 was 1,210,193,422. In spite of availability of wide range of contraceptives, the unmet need for family planning is estimated to be 12.8%. The common reasons for unmet need are unsatisfactory services, lack of information, and fear about side effects of contraceptive method. Studies show that pregnancies taking place within 24 months of previous birth have higher risk of adverse outcome like abortion, premature labour, postpartum hemorrhage, low birth weight babies, fetal loss, and maternal death. Apart from lactational amenorrhea, the methods which can be used by the women during postpartum period are barrier methods, progesterone only pills, sterilization (puerperal tubectomy) and IUCD (postpartum IUCD). IUCD insertion has many advantages over other methods like simplicity, minimal motivation, reversibility, free of cost availability, virtually no systemic side-effects, and high continuation rate. Insertion of IUCD in postpartum period has additional advantages of safety due to blunt insertion technique, and certainty of non-pregnancy of woman. Integrating IUCD insertion with delivery services optimizes opportunities for women to obtain an appropriate long term, reversible family planning method before returning home. Also it is seen that women are highly motivated and receptive to accept family planning methods during the postpartum period and this is the best time when a woman is in
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.
Safety and Efficacy of Intra-caesarean IUCD: A Prospective Study at a Tertiary Care Centre
The Journal of Obstetrics and Gynecology of India, 2019
Objective To assess the safety and efficacy of postpartum IUCD in caesarean section patients. Methods This prospective observational study included 200 women, who gave informed consent for postpartum intrauterine contraceptive device (PPIUCD) insertion during caesarean section from January 2013 to May 2014. These patients were followed up at 6 weeks and 6 months. Results There were no major complaints in either group in post-operative period. At 6-month follow-up in PPIUCD users, 89.5% of patients continued to use this method. 5.5% were lost to follow-up, 2.5% had spontaneous expulsion, and 2.5% removed the IUCD due to various reasons. Eight per cent of patients who wanted removal of IUCD in the second follow-up were counselled to continue, and they did so. Conclusion The results of our study suggest that immediate intra-caesarean IUCD insertion appears to be a safe and effective method of contraception. The acceptability of intra-caesarean IUCD was high, and its continuation rate has demonstrated its safety.
BMJ Sexual & Reproductive Health
BackgroundIntrauterine devices (IUDs) are highly effective contraception. IUDs inserted directly following delivery provide immediate birth control and may decrease unintended pregnancies, including short-interval pregnancies, thereby mitigating health risks and associated economic burden.MethodsThis systematic literature review included published global data on the utilisation, effectiveness, and safety of postpartum intrauterine devices (PPIUDs) of any type. English language articles indexed in MEDLINE, Embase, and Cochrane from January 2010–October 2021 were included.Results133 articles met the inclusion criteria (46% interventional studies; 54% observational; n=87 from lower-income countries; n=46 from higher-income countries). PPIUD use was low in higher-income countries (6/10 000 US deliveries in 2013–2016) and varied widely in lower-income countries (2%-46%). Across both higher- and lower-income countries, in most studies (79%), >80% of women with PPIUDs had an IUD in plac...
Evaluation of Safety, Efficacy and Complications of Postpatum Iucd in a Tertiary Instituite
2018
Original Research Paper Gynecology Background: For most women, including women who want to have children, contraception is not an option; it is a basic health care necessity. Aims and objectives: To assess the efficacy and feasibility of IUD (CuT 380-A) insertion immediately after delivery of placenta and to assess the post-insertion side-effects, complications & expulsion rate. Materials and methods: A study was conducted over a period of 2 years in a tertiary care institute in Mumbai. Open label, prospective, and longitudinal study. Postpartum IUCD was inserted as per the inclusion and exclusion criteria. Out of 451 women inserted with PPIUCD, 142 were intracesarean insertions. These patients were followed up at 6 weeks. Results: New advances and new understanding about PPIUCD led it to be safe and effective and with good retention rates; serves as useful method for family planning. There was no incidence of failure, perforation or PID. There was absolutely no complaints in 44.8%. expulsion rate was 2.4%. It necessitated removal only in 13.1%. Conclusion: PPIUCD is a right choice, when inserted with right technique, right instrument, right time. Expulsion rate minimal if correct insertion technique and with trained hands.
International Journal of Science and Research Archive, 2022
Introduction: PPIUCD is an emerging contraceptive method for women which is easily available, safe, efficient, long acting, reversible and available just after birth of baby. Aims and Objectives To study the efficacy of postplacental IUCD insertion in vaginal and cesarean delivaries. Comparative evaluation of postplacental IUCD in vaginal and cesarean insertion in terms of counseling and complications.
IOSR Journals , 2019
INTRODUCTION: PPIUCD is a promising approach in the field of family planning.Both vaginal insertion and intracesarean insertion of PPIUCD are safe in terms of complications and effective for spacing and limiting births. OBJECTIVE: Evaluation of safety and efficacy of vaginal and intra-cesarean insertion of PPIUCD.. IUCD used was CuT-380A.Study subjects were enrolled according to exclusion criteria and informed consent was taken. Patients were followed up at 4 weeks,3 months and 6 months. RESULTS: This study shows that PPIUCD is a promising method of contraception. It was highly acceptable,easily available method of contraception with only a few complications. The most common complication was found to be missing thread in both the groups (8% in vaginal group Vs 10% in caesarean group); which was followed by pain abdomen (6% in vaginal group Vs 5%in caesarean group). There was no complication of perforation or pregnancy in both the groups. CONCLUSION: Patient satisfaction was good in both methods of PPIUCD insertion. Use of IUCD in postpartum period can provide long term ,safe, reversible, coital independent and effective contraception.
Our aim was to study acceptability of PPIUCD in our target population, based on their demographic variables including parity and mode of delivery. Method : The study was conducted at V.S.General Hospital, Ahmedabad from 1stJune,2016 to 31December,2016.CuT 380A was inserted in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up for a period of one year, and studied the various complaints and complications associated with PPIUCD insertion. Conclusion: Both the acceptance and actual insertion of IUCD were low probably because the use of IUCD is a new concept in the community. 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. Even though expulsion rate high with IUCD, acceptance was high when it is inserted in postpartum period. Results: 2% of the women who delivered vaginally at VSGH, Ahmedabad chose PPIUCD and 7% of those who undergone C-Section chose PPIUCD.100 of those who received a PPIUCD (256) returned for a follow up visit which is 39%.48.04% of those who inserted IUCD were 2nd para and 37.5% primi para , 11% 3rd para and only 3.47% of 4th para opted for IUCD.6% of all patients demand removal and 3 % demand re-insertion.PPIUCD continuation rate in my study is 83.9%.Only 1 patient had misplaced IUCD in follow up, apart that no patient encountered any serious complication.
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.
Journal of Medical and Scientific Research, 2022
introduction: Immediate postpartum period is when women are receptive to family planning counselling. Pregnancy within a year of the last delivery increases maternal and perinatal morbidity and mortality. Postpartum intrauterine contraceptive device (PPIUCD) is one method which is safe and effective method for spacing and also for limiting pregnancy. This study was done to evaluate PPIUCD insertion for its awareness, acceptance, and expulsion. Materials and methods: All pregnant women were counselled regarding PPIUCD, and those willing were included in the study. Intrauterine contraceptive device used in this study was CuT 380A. It was inserted after delivery of the placenta after vaginal delivery and after caesarean section using sponge-holding forceps. They were asked to follow up after 6 weeks and 6 months of insertion. Data collected was subjected to statistical analysis using SPSS V22 software, and results were drawn. Results: From 1602 deliveries, 456 (28.46%) women accepted PPIUCD, and 36.32% (n=582) were aware of this method. 60.08% (n=274) had PPIUCD insertion after vaginal delivery and 39.91% (n=182) after caesarean section. The main reason for refusal was fear of bleeding (n=280) (26.81%). The most common complication seen was lower abdominal pain (11.62%). No case was reported with uterine perforation. conclusion: This method has shown to be a very safe, effective and economical method for contraception. In India, where there is very little access to contraception during interval period and women do not return to the hospital for a postnatal checkup and contraceptive advice, this PPIUCD method is most beneficial.