Publication:

Comparative study of IUCD inserted intracesarean and after vaginal delivery

Background In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective, long-term contraception such as intrauterine device (IUD) in post-partum women. The present study was planned to evaluate the safety and efficacy of immediate post-partum IUD insertion in women delivering vaginally or by caesarean section.

Methods The women recruited had CuT 380A insertion immediately after delivery of placenta in vaginal or caesarean delivery. Women having post-partum haemorrhage (PPH), anaemia, pre-labour rupture of membranes >18 h, obstructed labour and distorted uterine cavity by fibroid or by congenital malformation were excluded from the study. The women were followed up at 6 weeks after delivery.

Results A total of 500 women were included in the study. The present study shows that expulsion rate was more in postplacental insertion group i.e. 13.2% while among intracaesarean group it was 6.8% and this difference was statistically significant. Removal rate of PPIUCD (Post-partum Intrauterine Contraceptive device) was higher in postplacental insertion i.e.43 (17.2%) cases whereas in intracaesarean insertion removal rate was 8.4%. Most common cause of removal of PPIUCD in our study was pelvic pain and menstrual disturbances.

Conclusions Thus, from our study it is concluded that PPIUCD is safe, convenient, cost effective, reversible and long-term birth spacing method. It should be part of a maternal/newborn/reproductive health package.