Publication:

Comparison of continuation rate, safety and acceptability of intra-caesarean insertion of CuT 380A versus CuT 375: a randomized controlled study

Background The immediate postpartum period represents an important opportunity to initiate long-acting reversible contraception. Intracesarean insertion of PPIUCD is a convenient and effective method for preventing unintended pregnancies. CuT 380A and CuT 375 are widely used devices; however, comparative evidence regarding continuation and safety following intra-caesarean insertion is limited. To compare continuation rate, safety profile and acceptability of intra-caesarean insertion of CuT 380A and CuT 375.

Methods This prospective randomized controlled study was conducted in the Department of Obstetrics and Gynaecology, Kasturba Hospital, Delhi from August 2023 to October 2024. Total of 144 women undergoing caesarean section and consented for IUCD insertion were randomized into two groups: CuT 380A (n=72) and CuT 375 (n=72).  Participants were followed at 6 weeks, 3 months, 6 months and 9 months postpartum. Primary outcome was continuation rate. Secondary outcomes included expulsion, removal and complication

Results Mean age of participants was comparable between CuT 380A and CuT 375 groups (23.83±4.31 vs 23.33±4.00 years; p>0.05). Overall follow-up rate was 97.9%. Expulsion occurred in 5.5% women in CuT 380A group and 4.1% women in CuT 375 group (p>0.05). Removal rates were 6.9% and 2.7% respectively. Continuation rates at 9 months were 84.7% and 91.7% respectively.

Conclusions Both CuT 380A and CuT 375 are safe and effective for intra-caesarean insertion with comparable continuation and complication rates. CuT 375 demonstrated slightly higher continuation rates though differences were not statistically significant.