Factors Affecting Post Placental Intra-Uterine Contraceptive Device Insertion Rate

Abstract

Background and Objective:The immensely increasing rate of population is one of the biggest hindrances in the progress of under developing world including Pakistan. One of the main component of Sustained Millennium Development Goals was to reduce maternal mortality and morbidity by fulfilling the unmet needs of contraception. Keeping these challenges into consideration, program of Post Placental Intrauterine Contraceptive Device (PPIUCD) insertion was initiated at tertiary care hospital settings in Pakistan.Objective of this study is to explore the factors affecting the rate of PPIUCD insertion rate.Methods: This cross sectional study was carried out at the Government Teaching Hospital Shahdara Lahore, Pakistan within 15 months (July 2019 to Sep 2020). A total of 4474 pregnant females were included using non probability consecutive sampling. A trained counselorcounselled the patients regarding benefits of PPIUCD and predesigned structured proforma was filled regarding demographic data, obstetric data and other factors related to insertion of PPIUCD. After the subjects were delivered, PPIUCDs were inserted in consenting females. Data was analyzed for statistical inferences.Results: Out of the 3292 participants who qualified for insertion, 802 females consented for PPIUCD insertion with an average insertion rate of 24.36%. The main factor affecting rate of PPIUCD insertion was presence of a trained counselor. Conclusion:The counseling services by a trained counselor are imperative for success in PPIUCD insertion rate.

Intra-cesarean post placental introducer withdrawal IUD insertion technique: A new standardized technique for IUD insertion during cesarean section. A randomized controlled trial

“…The conventional technique of IUD insertion during cesarean section as described in previous studies is based on manual placement of the IUD in the uterine fundus and manual guide of the IUD threads through the cervix [7][8][9][10]. In some studies they used long curved Kelly's placental forceps, ovum forceps or the IUD introducer to ensure placement of the IUD in the uterine fundus [11,12]and in another they used the introducer to guide the threads in the cervix without clear description of this step Neither of the previous studies studied the value of technique modi cations on IUD side effects and complications. So, it is clear that there is a need for a standard technique for IUD insertion during cesarean section with the least possible side effects and complications.…”

Conventional manual technique of post placental IUD insertion versus intra-cesarean post placental introducer withdrawal IUD insertion technique: a new standardized technique for IUD insertion during cesarean section: a randomized controlled trial

“…The conventional technique of IUD insertion during cesarean section, as described in previous studies, is based on the manual placement of the IUD in the uterine fundus and manual guide of the IUD threads through the cervix [ 8 – 11 ]. In some studies, they used long curved Kelly’s placental forceps, ovum forceps, or the IUD introducer to ensure the placement of the IUD in the uterine fundus [ 12 , 13 ]. In another study, they used the introducer to guide the threads in the cervix without a clear description of this step [ 13 ].…”