scholarly journals Comparative study of post-partum intrauterine contraceptive device in vaginal and intra caesarean insertion

Author(s):  
Babita Kanwat ◽  
Lakshmi Salodia ◽  
Madhubala Chauhan ◽  
Radha Rastogi

Background: Institutional deliveries have increased all over the country, thereby providing opportunities for quality postpartum family planning services. In this period, women are highly receptive to accept family planning methods. Objective of this study was to evaluate CuT Multiload 375, in terms of acceptance, safety, efficacy, continuation rate, removal rate and to find out PPIUCD complications e.g. bleeding irregularities, perforation, expulsion and discontinuation due to various reasons.Methods: Prospective analytical study was conducted from February 2016 to June 2016 in the department of Obstetrics and Gynecology, at RNT Medical College, Udaipur, Rajasthan, India.100 patients in each vaginal and cesarean group were selected randomly. Multiload 375 was inserted after obtaining written consent.Results: Missing threads were detected more in cesarean group (22.8%) than vaginal group (12.9%). Cumulative expulsion rate was 15.2% in vaginal group and 10.8% in cesarean group. Heavy Bleeding PV with or without the pain was the main reason for removal of CuT in both the groups. Removal rate for vaginal and cesarean group was 15.2% and 10.8% respectively.Conclusions: PPIUCD is very effective, safe and reversible contraceptive method which provides contraceptive effect soon after birth. Although there is relatively high incidence of expulsions and removal in the both group still the continuation rate was 69.4% in vaginal group and 78% in cesarean group.

Author(s):  
Hiral P. Godhani ◽  
Dhaval K. Patel

Background: Family planning is important not only for population stabilization, but it has been increasingly recognized as central tool to improve maternal and neonatal health. Aim of current study was to compare interval and post partum intrauterine contraceptive device (IUCD) insertion in terms of effectiveness and safety.Methods: This was a prospective observational cohort study, done in the department of Obstetrics and Gynecology, GMERS Medical College, Sola, Ahmedabad, from August 2015 to April 2017 was taken for evaluation. 80 women in each group who were inserted IUCD after delivery and in the interval period were studied. Outcome was measured by expulsion rate, continuation rate, and incidence of dysfunctional uterine bleeding (DUB), Pelvic inflammatory disease (PID), failure rate and effect on puerperium.Results: Expulsion rate in PPIUCD group was 8.75% while in interval IUCD group it was 1.25%. Continuation rate following Postpartum intrauterine contraceptive device (PPIUCD) and interval IUCD insertion was 86.25% and 95% respectively. Incidence of bleeding per vaginum (menorrhagia) was 7.5% in PPIUCD group while 8.75% in interval IUCD group. There was one case 1.25% of PID in interval IUCD group while no case in PPIUCD was noted. Failure rate was nil in both the group. There was no effect on puerperium following PPIUCD insertion group during present study.Conclusions: PPIUCD is an effective and safe spacing method of contraception as compared to interval IUCD insertion. There is no statistically significant change in incidence of expulsion rate, continuation rate and other complications in both the group.


Author(s):  
Archana Goyal ◽  
Rekha Wadhwani

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.


Author(s):  
Sravani Mukka ◽  
Madhavi Y.

Background: In India almost 65% of the women have an unmet need for family planning in the first postpartum year. Increasing rates of institutional deliveries creates an opportunity for providing quality post-partum family planning services. Post-partum Intrauterine contraceptive device (PPIUCD), a form of long acting reversible contraception (LARC) is one of the most affective and safest method available. The present study aims at evaluating the safety, efficacy, rate of acceptance and rate of discontinuation of Intra caesarean inserted contraceptive device Copper T-380A.Methods: This was a prospective study conducted at ESIC Medical College, Sanathnagar in women delivered by caesarean section during the period between March 2018 to February 2019. Recruitment was done based on the WHO medical eligibility criteria (MEC) for PPIUCD and also their willingness to participate in the study. Follow-up visits were scheduled at 6 weeks, 3 months and 6 months.Results: Of the 265 women fulfilling the WHO MEC, 180 (67.92%) were willing to participate in the study. Total acceptance rate was 67.7%. Majority of them belonged to the age group 21-30 years (80%) and para 2 (53.88). 93.3% of the women were literates. 12 (6.66%) cases lost to follow up and the complications were studied in the rest 168 women. During follow up -38.69% had missing strings, 12.5% menstrual disturbances, 4.76% abdominal pain and spontaneous expulsion in 4.1%. No cases of perforation and pregnancy were reported. Total continuation rate was 84%.Conclusions: PPIUCD is a safe and convenient option of contraception with low expulsion rates and high continuation rates.


Author(s):  
Radhika Chethan ◽  
Anitha G. S. ◽  
Savitha C.

Background: Post partum contraception is the best evidence based intervention in prevention of pregnancy and abortion related maternal morbidity and mortality in the developing countries. The unmet need for contraception among women in the postpartum period can be effectively fulfilled by post partum insertion of IUCD, in a single visit under the Government scheme of providing free maternity services during institutional delivery. Despite optimal efforts by family planning program, very few couples are opting for spacing methods and lack of awareness has resulted in discontinuation of family planning methods particularly PPIUCD. This study is designed to study the practices of PPIUCD and causes for discontinuation at follow up in our hospital. The objectives of the study were study PPIUCD practices at Vanivilas hospital; causes for discontinuation of PPIUCD.Methods: Prospective study done at Vanivilas hospital attached to Bangalore Medical College and Research Institute from January 2014 to December 2014. Women admitted and delivered at VVH, were counselled. CuT 380A was inserted in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till June 2016.Results: There were 2072 PPIUCD insertions in one year, out of which 1244 were post placental, 139 were in immediate postpartum and 689 were intra caesarean insertions. Fifty four (54) women discontinued PPIUCD during follow up .Main causes for removal were menstrual abnormalities (19), pain abdomen (13), wanting sterilisation procedure (12) and marital disharmony.Conclusions: PPIUCD is an effective, safe, reversible method of long term contraception with high reported expulsion and low perforation rate, compared to interval insertion. More research is needed in the field of PPIUCD to enhance awareness and acceptance in the community. Awareness and counselling the eligible couples during ante natal care can improve acceptance and compliance of PPIUCD continuation rates.


Author(s):  
Nidhi Gupta ◽  
Renuka Sinha ◽  
Abha Mangal

Background: The objectives of the study were to assess knowledge, attitude and practice in post-partum intrauterine contraceptive device method of family planning and to know about willingness for post-partum intrauterine contraceptive device (PPIUCD) when knowledge is provided for the same.Methods: This is a cross sectional observational study including 1200 patients of immediate post-partum period (<48 hrs of delivery), delivered at Safdarjung hospital. Women were evaluated with the help of a pre-designed and pre-tested questionnaire.Results: Out of 1200 women 864 (72%) were aware of some family planning method but only 672 (56%) had used some family planning method in the past. 108 (9%) women had knowledge regarding Post-partum intrauterine contraceptive device (PPIUCD). Among these, 72 (6%) women opted for PPIUCD. After knowledge regarding PPIUCD had been given, 80 more women adopted this as a method of contraception. So total 152 (12.67%) opted PPIUCD.Conclusions: This study highlights that awareness and knowledge does not always lead to use of contraceptives. A lot of educational and motivational activities are needed.


Author(s):  
Rupali Atmaram Gaikwad ◽  
Shrinivas N. Gadappa ◽  
Sonali S. Deshpande

Background: In this modern or scientific era even though women are working equally or one step ahead of men, in family planning decision they are still lagging behind. Postpartum period is very crucial for a woman especially for many of those belonging to the villages as this may be the only time she comes in contact with a health personnel and in a mood to listen health advice. Keeping this in mind, this crucial period was considered as opportunity to test the issue of awareness regarding contraception.Methods: We conducted a cross-sectional study in the department of obstetrics and gynecology of Govt medical college and hospital, Aurangabad between August 2016 to December 2016. A total 720 post-partum women were interrogated and counselled regarding various methods of contraception.Results: Only 55.69% were aware about various methods of contraception. Awareness was maximum for Sterilisation (91%) followed by Intrauterine contraceptive device (81%) and Oral contraceptive pills (41%). Women knew about contraception from health care system (45%) and mass media (36%). After counselling 97% patients ready to use.Conclusions: There is lack of awareness regarding contraception. Contraceptive services are to be strengthened by intergrating with antenatal sevices.


2021 ◽  
pp. 65-66
Author(s):  
Anita Pathak

To evaluate the efcacy and long-term safety effect of post partum intrauterine contraceptive device after vaginal and cesarean birth in NMCH, Patna over a period of 12months. Atotal of 300 women who opted for PPIUCD, whether delivered vaginally or by cesarean were enrolled into study at NMCH, Dept. of Obst & Gynae, Patna. Both modes of PPIUCD Insertion were found to have very low rate of expulsion, vaginal bleeding, missing strings and also effective as contraceptive. Strings of PPIUCD were less visible after cesarean insertion than vaginal insertion. Expulsion rate was 5% in vaginal group and 2% in intra-cesarean group. PPIUCD is an appealing approach and may become the best choice as post partum contraception after vaginal as well as cesarean delivery.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Gebremedhin M ◽  
◽  
Alemayehu A ◽  
Yihune M ◽  
Melis T ◽  
...  

Background: An intrauterine contraceptive device is suitable for women of all reproductive age groups for preventing unwanted pregnancies. Immediate post partum family planning services need to be emphasized where in the woman leaves the hospital with safe and effective contraception in place. Despite the accepted demand for post partum family planning, many women do not access the services they need prevent unintended pregnancies. Objective: To assess utilization of immediate postpartum intrauterine contraceptive device and associated factors among women who gave birth at government hospitals of Gamo Zone, Southern Ethiopia. Method: Facility-based crosses sectional study was conducted from March 1 to 30 of 452 participants were studied using systematic random sampling technique. Data were entered into Epi-data v. 4.2.2.1 and exported to SPSS v.23 for analysis. Crude or adjusted odds ratio, and 95% confidence interval were used to assess the strength of association and statistical significance. Variables which had a p-value of ≤0.25 in bivariate analysis were considered as candidates for multivariate regression analysis; variables that had a p-value of ≤0.05 in the multivariate analysis were considered as independent factors associated with utilization of immediate postpartum intrauterine contraceptive device among parturients in the final multiple logistic regression analysis. Results: This finding revealed that about 161 (36%) of the respondents had showed willingness to use immediate PPIUD, however, only about 62 (14%) of study participants were utilized immediate PPIUCD. Mothers who did not plan to have another child (AOR = 2.84, 95% CI, (1.12, 7.21), undecided plan to have another child (AOR = 2.55, 95% CI, (1.21, 5.35), counselled about PPIUCD (AOR=4.35, 95% CI, (2.11, 8.96) and completed ANC follow up (AOR=2.43, 95% CI, (1.28, 4.60) were associated with immediate post partum contraceptive device utilization. Conclusion and Recommendation: Even though 58% and 53% of the mothers were counselled and completed antenatal service respectively but efforts need to improve antenatal care service and integrate counselling service through the whole cascade of pregnancy.


2021 ◽  
pp. 44-46
Author(s):  
Sumit Ranjan Pramanick ◽  
Saumen Mandal ◽  
Bharat Chandra Mandi ◽  
Debarshi Jana

Introduction: 1 India's population has crossed one billion in the year 2000. In recent censes of 2011 it has reached 121 crores and it is estimated to 2 reach a gure of1.53 billion by 2050, making it the most populous country in the world . India is the rst country in the world to adopt an ofcial population policy and launch ofcial family planning programme way back in 1952, which remains the mainstay of family planning efforts. Aims and objectives: 1. To nd out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. 2. To assess the complications of post placental &intra caesarean PPIUCD if any among these acceptors. 3. To determine the spontaneous expulsion rate of this contraceptive device. Materials and methods: All Adult ANC women attending SSKM hospital at Gynae OPD and as well as admitted in hospital wards or Labour Room who will full the inclusion criteria during data collection period. Conclusion: The study results, it can be concluded that PPIUCD in the eld of PPFP is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and efcacious in terms of safety and efcacy.


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