Evaluation of safety, efficacy, acceptance and expulsion of post placental intrauterine contraceptive device in a tertiary care centre

Abstract

Background: Postpartum intrauterine device provides an effective temporary method of contraception for the woman who needs birth spacing rather than birth limitation and also a quasi-permanent family planning method. The aim of this study was to study the efficacy, acceptance, safety and complication of PPIUCD insertion.Method: This a retrospective analytical study done in a tertiary care teaching institute, Institute of Obstetrics and Gynaecology Egmore for a six-year period from January 2010 to December 2015 with a sample size of 81204. Outcomes measured were safety, efficacy, acceptance (patients and professionals) and complications.Results: For the study period of six years the total number of women delivered were 81204. A steady increase was noted in the insertion of PPIUCD from 2010 (1.98%) to 2015 (58%). 50.5% had insertion following caesarean section and 49.5% following vaginal delivery. Primipara had a higher rate of acceptance amounting to 74.74%. Most common complication reported was missing strings 9.25% and a greater part of the patients (83%) did not have any complaints.Conclusions: Enthusiasm and conviction on the part of the health care provider goes a long way in improving the acceptance rate of PPIUCD. It is an indispensable contraceptive tool for our country since our women most often do not return for postnatal contraceptive options.

A preliminary feasibility study to evaluate the safety, acceptability and efficacy of PPIUCD prior to implementation of PPIUCD service

“…In a large study spanning over 6 years, the insertion rate following Caesarean section and vaginal delivery was almost equal with postpartum <48hrs insertions being a very small proportion, 3.5%. 17 An analysis of reasons for acceptance has revealed that long term duration and the safety profile of PPIUCD were the prime reasons which motivated the women in our study. In other studies the reasons for acceptance were diverse such as 'my doctors' advice must be a good one', 'no remembrance once inserted' (Mishra S et al).…”