Comparative study of post-partum intrauterine contraceptive device in vaginal and intra caesarean insertion

Abstract

INTRODUCTIONInstitutional deliveries have increased all over the country, thereby providing opportunities for quality postpartum family planning services. In this period, women are highly receptive and motivated to accept family planning methods. Ideally birth to birth interval is 36 months; but 61% of births in our country are shorter then recommended interval. 27% of births occur within 24 months, 34% births between 24 to 35 months after a previous birth. In the first postpartum year, 65% of women have an unmet need for family planning in our country. In this period only 26% of women are using any method of family planning. So healthy spacing of pregnancy must be achieved by postpartum family planning methods.1 Fear of complications and lack of information are the common problems for unmet need. Postpartum insertion of IUCD for spacing and limiting birth is very safe and effective approach, should be implemented in all deliveries ideally.According to Medical Eligibility Criteria of WHO, an IUCD can be inserted within 48 hours postpartum or after 6 weeks following birth. Generally, it is not used between 48 hours to six weeks postpartum as there is increased chances of expulsion and infection (WHO category 3) as ABSTRACT Background: Institutional deliveries have increased all over the country, thereby providing opportunities for quality postpartum family planning services. In this period, women are highly receptive to accept family planning methods. Objective of this study was to evaluate CuT Multiload 375, in terms of acceptance, safety, efficacy, continuation rate, removal rate and to find out PPIUCD complications e.g. bleeding irregularities, perforation, expulsion and discontinuation due to various reasons. Methods: Prospective analytical study was conducted from February 2016 to June 2016 in the department of Obstetrics and Gynecology, at RNT Medical College, Udaipur, Rajasthan, India.100 patients in each vaginal and cesarean group were selected randomly. Multiload 375 was inserted after obtaining written consent. Results: Missing threads were detected more in cesarean group (22.8%) than vaginal group (12.9%). Cumulative expulsion rate was 15.2% in vaginal group and 10.8% in cesarean group. Heavy Bleeding PV with or without the pain was the main reason for removal of CuT in both the groups. Removal rate for vaginal and cesarean group was 15.2% and 10.8% respectively. Conclusions: PPIUCD is very effective, safe and reversible contraceptive method which provides contraceptive effect soon after birth. Although there is relatively high incidence of expulsions and removal in the both group still the continuation rate was 69.4% in vaginal group and 78% in cesarean group.

Postpartum Intrauterine Contraceptive Device – A Follow up Study of Clinical Outcomes

“…In this study we found that there is no case of uterine perforation present in our study which is similar to study conducted by various authors [8][9][10] . This may be due to good selection and better management of the patients.…”

Awareness and Acceptance of Post-Partum Intrauterine Contraceptive Device Insertion (PPIUCD) among Patients Attending a Tertiary Care Hospital Karachi

“…However, Around 85% (170) women had inadequate awareness of the method and had declined to use as PPIUCD due to no previous knowledge or information The acceptance rate was 12% was similar with some other related studies. In other study it was found that the acceptance rate was not increasing over a long period of time [12][13] . The age group that showed the higher acceptance rate was between 25-30 years (35%).…”

Comparison of Continuation of Post-Placental Insertion of Copper T After Cesarean Section and Normal Vaginal Delivery

“…The mean age of acceptors in vaginal group was 26.28±4.367 years and in LSCS group it was 26.02±3.67 years. Kanwat et al reported that mean age of acceptors was comparable in the both groups, being 24.42±3.79 years in vaginal and 24.20±3.42 years in cesarean group [8].…”