Prospective Study for Evaluation of PPIUCD Insertion as a Method of Contraception

Abstract

Background : Now a days institutional deliveries have increased in India, thereby providing opportunities for
quality postpartum family planning services. Post placental intra-uterine device has many advantages like
providing contraception immediately after childbirth, non-interference with lactation and high efficacy. This study
aims to compare the complication rates following insertion of immediate post placental IUCD (PPIUCD) with
interval insertion.
Methods : Prospective analytical study was conducted from January 2018 to December 2018 department of
Obstetrics and Gynaecology, at GMERS medical college, Sola, Ahmedabad, India. After counselling with patients
and her relatives during antepartum period, IUCD insertion was done in 719 patients, out which in 208 patients
inserted vaginally and 511 patients during caesareansection. These patients were evaluated at 6 weeks and 6
months regularly.
Results : Both methods were found effective and safe. Out of 719 patients,670 patients had followed up as per
protocol. 29 cases who lost for follow up and 20 cases who had spontaneous expulsion were excluded from study.
Missing threads were detected more in caesarean group (30%) than vaginal group (19%). One of the
disadvantages of PPIUCD is the high rate of expulsion, Most of the expulsions occur within 3 months of delivery.
No pregnancy and perforation were documented in the study.
Conclusion : PPIUCD is very effective, safe and reversible contraceptive method which provides contraceptive
effect soon after birth. The PPIUCD is a long-acting reversible contraceptive method that is suitable for use in all
women in postpartumperiod. Missing strings after PPIUCD insertion is a common problem encountered during
follow up examination and better management has to be provided.