Objectives Evaluation and comparison of safety and efficacy of vaginal and intra-cesarean insertion of PostPartum 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.

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In a multicentre trial (3 centres) the safety and efficacy of an intramuscular injection of 125 µg of 15(S)15 methyl PGF (Prostin 15M, Upjohn) was compared with methylergometrine for prophylactic control of bleeding during the third stage of labour. Three hundred patients were recruited for the study - 150 to each treatment group. The duration of the third stage was shorter in the patients (4.4 minutes) treated with Prostin 15M compared to the methylergometrine group (8.6 minutes). Similarly the blood loss during the third stage was reduced by 50% of that observed in the methylergometrine group (72 ml vs 145 ml). Prostin 15M, when used prophylactically was better than methylergometrine in controlling the blood loss during the third stage of labour.

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