INTRODUCTIONOptimal birth spacing and birth control are issues that caught the attention of global reproductive health services. Multiple studies show that adverse maternal and perinatal outcome is related to closely spaced pregnancies. Approximately 27% births in India occur <24 months after a previous birth and another 34% between 24 -35 months.1 61% of births in India occur at intervals shorter than the recommended birth-to-birth interval of 36 months. The study shows that 65% of women in the first year postpartum have an unmet need for family planning. Postpartum period is a highly vulnerable period for unintended pregnancy as there are limited contraceptive options for breastfeeding mothers. Moreover return of ovulation is highly unpredictable in those not on exclusive breastfeeding. So immediate postpartum is the ideal time to begin contraception as women is strongly motivated at this time.Government of India has launched several programs which emphasizes on promotion of adequate birth spacing. In India where government is promoting institutional deliveries, also creates opportunities for ABSTRACTBackground: 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. Data are expressed in frequency and percentage. Chi square test was used for comparison and P value <0.05 was considered significant. Results: The study shows that PPIUCD is an effective intervention in both cesarean and vaginal delivery with no significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation or failure and no significant risk of infection in either group. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the cesarean group compared to vaginal insertion. Conclusions: PPIUCD is a safe effective and convenient method of contraception and should be encouraged in both vaginal and cesarean deliveries.

respectively. The oocyte areas at tPNfb and tPNf were significantly smaller than those at tICSI, tPB2b, and tPB2 (P <0.05). Study 2: The multivariable logistic regression analysis showed that clinical pregnancy had significant associations with group A (area of tPNfb / tPB2b, aOR: 4.8, 95% CI: 1.07-23.08, p<0.05) and group B (area of tPNf / tPB2b, aOR: 7.3, 95% CI: 1.22-47.58, p<0.05), but not with group C (area of tPNf / tPNfb, aOR: 2.08, 95% CI: 0.30-14.1, p¼0.4549).CONCLUSIONS: A significant decrease in oocyte cytoplasmic volume was observed from sperm penetration to PN fading. In addition, there were significant associations between clinical pregnancy and the degree of cytoplasmic volume change from 2 nd PB extrusion to PN fading. These results suggest that the regulation of oocyte cytoplasmic volume during fertilization would influence oocyte competence, which may predict successful pregnancy after SET.SUPPORT: None.