scholarly journals A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

2018 ◽  
Vol 7 (9) ◽  
pp. 3826
Author(s):  
Sharmistha Sarkar ◽  
Dhruba Prasad Paul ◽  
Jayanta Ray
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Comparative Evaluation ◽  
P Value ◽  
Contraceptive Device ◽  
Government Medical College ◽  
Expulsion Rate ◽  
Medical College ◽  
Significant Difference ◽  
Post Placental

Background: Adverse maternal and perinatal outcomes are related to pregnancies spaced too closely together. Objective of present study was to compare the expulsion rate and complications between post placental IUCD insertion between caesarean section and vaginal delivery.Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.Results: There was no significant difference in either complications between the two groups (P value-.913) or outcomes (p value-.035). Expulsion rate 18.2% following vaginal delivery compared to those with intracaesarean insertion i.e 3.8%.Conclusions: The complications associated with postplacental Intrauterine device insertion is insignificant, still the awareness, acceptance and continuation are very low. Therefore Information, education Communication activity by the field workers must be enhanced to overcome this knowledge gap.

scholarly journals Clinical Outcomes of Trans-caesarean and Vaginal Post-placental CuT380A IUCD Insertions: A Comparative Study

2021 ◽  
pp. 46-57
Author(s):  
C. P. Okoye ◽  
D. N. Onwusulu ◽  
C. P. Nnamani
Keyword(s):  
Clinical Outcomes ◽  
Post Partum ◽  
Sampling Technique ◽  
Categorical Variables ◽  
P Value ◽  
Contraceptive Device ◽  
Continuous Variables ◽  
Expulsion Rate ◽  
Post Placental ◽  
Pregnant Mothers

Background: Immediate postpartum CuT380A intrauterine contraceptive device (PPIUCD) insertion provides a novel approach in reducing the unmet contraceptive needs of family planning. The insertion can be trans-caesarean or vaginal following delivery of the placenta. The clinical outcomes of the different routes of insertion have not been adequately studied. Aim: The study aimed at comparing the clinical outcomes following trans-caesarean and vaginal post-placental insertions of CuT380A IUCD. Methodology: The study was a prospective cohort study of 81 pregnant mothers managed at a tertiary health institution in southern Nigeria. They were recruited into two groups using a convenient sampling technique; 27 and 54 mothers in the caesarean and vaginal delivery groups respectively. The pregnant mothers were followed up till delivery and at the six weeks postnatal visit. Information on their socio-demographic characteristics, Obstetrics and Gynecology history were obtained with the aid of a proforma. The proforma was updated with the clinical outcomes of immediate PPIUCD insertions in the two groups, at the six weeks visit. Data obtained were analyzed using statistical package of social sciences version 21. Continuous variables were expressed as means and standard deviations. The Chi square test was used for dichotomous or categorical variables. A p-value of less than 0.05 was considered statistically significant. Results: The study showed that PPIUCD is a safe practice in both vaginal and caesarean deliveries with no significant differences in clinical outcomes. However, incidence of missing string was higher in the caesarean group compared to vaginal group (81.5% vs 51.9%; p value-0.01); and expulsion rate was also high in the vaginal group but not significant. (13.0% vs 7.4%; p value 0.45). Conclusion: Immediate postpartum CuT380A contraception, irrespective of route of insertion, is convenient, effective, and safe. Although there is a relatively higher incidence of missing strings, including expulsions after vaginal PPIUCD insertions, immediate post-partum contraception should be encouraged. This will help to reduce high unmet contraceptive needs in our environment and loss to follow up irrespective of route of delivery. Recommendation: Immediate PPIUCD, irrespective of the route, should be encouraged and integrated into the existing Maternal and Child Health Programme. Awareness should be created to promote acceptance in our environment.

scholarly journals Prediction of Foetal Well-being with Non-stress Test

2016 ◽  
Vol 33 (2) ◽  
pp. 65-69
Author(s):  
Jahanara Rahman ◽  
Hosne Ara Begum
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Apgar Score ◽  
Stress Test ◽  
The Other ◽  
P Value ◽  
Mild Depression ◽  
Other Hand ◽  
Significant Difference

Introduction: Non-stress test (NST) is the most common antenatal test performed to assess the foetus at risk of intrauterine hypoxia. On the other hand non-reactivity detected by NST increases the interferences of pregnancy by Caesarean section.Methodology: A cross sectional descriptive study was carried out in the department of Obstetrics and Gynaecology at Dhaka National Medical College between July2007 and June 2008.Objectives: The objectives of the study were (1) To observe the mode of delivery in cases of non-reactive non stress test (NST) and (2) To evaluate perinatal outcome of non-reactive NST.Results: A total 137 high risk pregnant women were included in the study. Age of the women ranges from 16 to 32 years. The mean age of the women was 23.74 ± 3.71 year. Among them 44.53% were primaegravida and 55.47% were multigravida. Gestational age was between 35 and 42 weeks and mean gestational age was 38.34±1.42 weeks. Regarding foetal reactivity 61.3% (n=84) were reactive and 38.7 % (n=53) were non-reactive. Among the babies of non reactive NST 98.11% and 1.89% were delivered by caesarean section and vaginal delivery respectively. Whereas, 48.81% and 51.19% babies of reactive NST were delivered by caesarean section and vaginal delivery respectively. The percentage of caesarean section was much higher in non-reactive NST cases in comparison to that of reactive NST which was statistically highly significant (p value 0.0000). One minute after birth APGAR scoring revealed that 56.6% and 43.4% newborn of non-reactive NST had no depression( APGAR score 7-10) and mild depression ( APGAR score 4-6) respectively. On the other hand 65.47% and 34.5% newborn of reactive NST had no depression and mild depression respectively at one minute after birth. Therefore, small difference was noticed in the neonatal status between the reactive and non-reactive NST which had no statistical significance (p value 0.507). Evaluation of the neonates with APGAR scoring done 5 minutes after birth revealed mild depression (APGAR score 4-6) in 24.53% and 20.24% of non-reactive and reactive NST cases respectively and no depression (APGAR score 7- 10) was found in 75.47% and 70.76% in reactive and nonreactive NST respectively. So, 5 minutes after birth the neonatal status among reactive and non-reactive NST made no significant difference (p value 0.9266).Conclusion: Neonatal evaluation revealed that all foetuses were not compromised as detected by NST. Relying on NST the rate of Caesarean section has been increased. Reassessment of the foetal conditions was needed with the help of other techniques. Therefore NST alone is insufficiently predictive of neonatal outcome.J Bangladesh Coll Phys Surg 2015; 33(2): 65-69

scholarly journals Analysis of postpartum intrauterine contraceptive devices

2021 ◽  
Vol 10 (5) ◽  
pp. 1856
Author(s):  
Sandhya A. Shrigadhi ◽  
Prabhakar S. Gawandi
Keyword(s):  
Family Planning ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Planning Method ◽  
Family Planning Method ◽  
Expulsion Rate ◽  
Medical College ◽  
Contraceptive Devices ◽  
Group Rate ◽  
Long Acting

Background: PPIUCDs are the only postpartum family planning  method for couples requesting a highly effective and reversible, yet long acting, family planning method that can be initiated during the immediate postpartum in lactating women. The public health benefits from PPIUCDs stemmed from the women’s increased accessibility to PPIUCDs following facility births, as PPIUCDs could be offered at health facilities after childbirth. It is an attempt to reduce unmet family planning need. The specific aims of this study were to assess the acceptability, feasibility expulsion rate and complications of PPIUCD insertion among women delivering at term in our institute who were eligible and counselled for PPIUCD.Methods: Prospective study undertaken at Dr. Vaishampayan memorial government medical college, Solapur, Maharashtra conducted from September 2015 to August 2017. All women undergoing delivery at term in this institute and not having any contraindications for postpartum IUCD insertion were counseled for PPIUCD.Results: A total 3032 were eligible for PPIUCD insertion and were counseled for the same. 1.97% women accepted PPIUCD insertion while 98.03% of them declined insertion. 1124 underwent caesarean section while 1908 had vaginal delivery. Among vaginal delivery group rate of acceptance was 1.20% while that in caesarean section group was 3.29%.Conclusions: The present study concluded that overall acceptance of PPIUCD in our institute is 1.97 %. Considering fear of complications related to IUCD and partner refusal as major causes of refusal for PPIUCD in our study, emphasis on this aspect during counseling can improve acceptance.

scholarly journals Evaluation of acceptability, safety and expulsion rate of PPIUCD

2018 ◽  
Vol 7 (3) ◽  
pp. 1083
Author(s):  
R. Chauhan ◽  
Sonal Sahni ◽  
Shaily Hanumantaiya
Keyword(s):  
Cost Effective ◽  
Contraceptive Device ◽  
Low Literacy ◽  
Eligibility Criteria ◽  
Expulsion Rate ◽  
Medical College ◽  
Antenatal Counseling ◽  
Post Placental ◽  
Long Acting

Background: The modern intrauterine contraceptive device (IUCD) is highly effective, safe, private, long acting, coitus independent, rapidly reversible, cost effective and can be used by women who are breastfeeding. This study was conducted to evaluate factors associated with acceptability, safety and expulsion rates of PPIUCD among clients in the Department of Obstetrics and Gynecology, N. S. C. B Medical College, Jabalpur.Methods: A questionnaire based prospective study was conducted between March 2016 -17 on all the clients who were counseled for PPIUCD and who fulfilled the WHO Medical Eligibility criteria. Proforma included follow up at 6 weeks post-delivery.Results: In our study 961 women accepted PPIUCD (53.3%). Majority of the cases belonged to low socioeconomic group with low literacy rates. Most acceptors counseled in antenatal period (53.1%). Majority (67.3%) of insertions were post placental and instrumental (89%). At the time of insertion most clients experienced mild pain (49.7%) & anxiety (42.5%). Amongst clients who followed up (51.1%), the most common complaint was pain (16.7%) and most common reason for removal was heavy bleeding. Continuation rate was 77.7%, spontaneous expulsion in 9.75% while voluntarily removal was done in 12.6%. At follow up 91.3% clients were satisfied with PPIUCD.Conclusions: Antenatal counseling has a very important role. Demographic factors influencing acceptance are education, socioeconomic status and family structure. PPIUCD is demonstrably safe and effective method of contraception with low expulsion rate. Awareness about the safety and efficacy of PPIUCD should be emphasized during antenatal visits.

scholarly journals Comparison of clinical outcomes following CuT-380A insertion in postplacental period with interval insertion

2017 ◽  
Vol 6 (9) ◽  
pp. 4111
Author(s):  
Divya Chauhan ◽  
Shalini Gainder
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Abnormal Uterine Bleeding ◽  
Complication Rates ◽  
Expulsion Rate ◽  
Interval Group ◽  
Obstetrics And Gynaecology ◽  
Significant Difference ◽  
A Prospective Study

Background: Postplacental intra-uterine device has many benefits like providing contraception immediately after childbirth, non-interference with lactation and high efficacy. However, concerns about its safety have led to decreased use of this method of contraception. Hence, this study aims to compare the complication rates following insertion of immediate postplacental IUCD (PPIUCD) with interval insertion.Methods: This is a prospective study conducted under the Department of Obstetrics and Gynaecology in PGIMER, Chandigarh. 196 women were included in the study. Women were divided in two groups, those who were inserted with immediate postplacental IUCD versus those who had IUCD insertion in interval period. The two groups were followed up for a period of 6 months and complications were recorded. The PPIUCD group was further subdivided into 2 subgroups based on mode of delivery, vaginal delivery and caesarean section. These PPIUCD subgroups were also compared.Results: There was no statistically significant difference in the incidence of pelvic pain, infection, abnormal uterine bleeding and expulsion between the PPIUCD and interval group. However, when the PPIUCD subgroups were compared, it was seen that no woman in caesarean section subgroup had expulsion of IUCD whereas 9.8% women had expulsion in the vaginal delivery PPIUCD subgroup.Conclusions: Postplacental and interval IUCD seem to be comparable for the incidence of various complications. However, intra-caesarean PPIUCD insertion seems to have a much lower expulsion rate as compared to vaginal delivery PPIUCD insertion.

scholarly journals COMPARISON OF POST PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE INSERTION BETWEEN VAGINAL DELIVERY AND CAESAREAN SECTION IN A TERTIARY CARE HOSPITAL

2020 ◽  
Vol 70 (6) ◽  
pp. 1707-11
Author(s):  
Saira Tasneem ◽  
Sanum Kashif ◽  
Erum Pervaiz ◽  
Faisal Azam
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Acceptance Rate ◽  
Intrauterine Contraceptive Device ◽  
Normal Vaginal Delivery ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive ◽  
Post Placental

Objective: To compare the acceptability of insertion of post placental intra uterine contraceptive device, withrespect to gravidity between vaginal deliveries and caesarean sections. Study Design: Prospective comparative study. Place and Duration of Study: Frontier Corp Hospital, Quetta, from Jan 2019 to Jan 2020. Methodology: A total of 399 females with age of 18 to 45 years with gravidity (primi, multi and grand multigravida) were counselled during antenatal visits about benefits and risks of post placental intrauterine contraceptive device (PPIUCD) insertion. For complications, females were assessed at 1 and 6 weeks after delivery. Results: A total of 399 females with mean age 27.95 ± 5.07 years were included in study. About 235 (55.9%)women delivered vaginally and 164 (41.4%) women by caesarean section. Acceptance rate was 3.8% and 4.3% for vaginal and caesarean deliveries respectively. Eleven (73.3%) women were grand multi gravida and 4 women(26.6%) were multi gravid in vaginal delivery acceptance group versus 8 women (47%) grand multi and 9 women (52.9%) multi gravida in caesarean acceptance group. Five (15%) females presented with complications (3 with abdominal pain and 1 each with infection and expulsion). Conclusion: The overall acceptance rate of PPIUCD was low in this study, the acceptance rate was higher inwomen undergoing normal vaginal delivery (NVD) as compared to lower segment caesarean section (LSCS),similarly more of the grand multiparas accepted the method as compared to other participants however thedifferences were not statistically significant.

scholarly journals Infection and Expulsion Rate of Intrauterine Contraceptive Device After Post Caesarean Vs Interval Insertion

2021 ◽  
Vol 15 (5) ◽  
pp. 906-909
Author(s):  
Zille Hyder Syed ◽  
Maryam Matloob ◽  
Rubina Qasim ◽  
Wafa Najeeb
Keyword(s):  
Infection Rate ◽  
Null Hypothesis ◽  
Controlled Trial ◽  
Elective Caesarean Section ◽  
P Value ◽  
Contraceptive Device ◽  
Expulsion Rate ◽  
Significant Difference ◽  
The Difference ◽  
Group B

Aim: To compare the frequency of infection and expulsion following insertion of IUCD immediate post casarean to that of interval insertion in parturient undergoing elective caesarean section Method: This Randomized controlled trial was conducted from 21 February to 20th August 2010. Results: It was observed that in immediate post cesarean group(Group A) expulsion rate was 8.1% and infection rate 7.2% where as in interval insertion group(Group B) expulsion rate was 10.9%and infection rate was 9.0%. The difference of expulsion rate was statistically significant in two groups (p value 0.491) i.e expulsion rate was proven to be significantly higher in interval insertion group than immediate trans cesarean insertion group. The difference of infection rate was not statistically significant between two groups (p value 0.623) although infection rate was found to be higher in interval insertion group but not clinically significant difference was found. Conclusion: Null hypothesis was rejected for expulsion rate of IUCD and a statistically significant increased expulsion rate was found in interval insertion group as compared to immediate post cesarean insertion group. Null hypothesis was accepted for infection rate after IUCD placement in two groups as no statistically significant increased infection rate was found between immediate post cesarean and interval insertion groups Keywords: Expulsion rate, infection rate,immediate post cesarean insertion,interval insertion.

scholarly journals Two years follow up study of post placental insertion of IUCD during caesarean sections: safety, efficacy and complications

2018 ◽  
Vol 7 (3) ◽  
pp. 981
Author(s):  
Dilpreet Kaur Pandher ◽  
Shikha Rani ◽  
Poonam Goel
Keyword(s):  
Caesarean Section ◽  
Unwanted Pregnancy ◽  
Outcome Analysis ◽  
Eligibility Criteria ◽  
Expulsion Rate ◽  
Medical College ◽  
Increased Risk ◽  
Post Placental ◽  
Lost To Follow Up

Background: The present study evaluates safety, efficacy, expulsion rate and complications of PPIUCD insertion in women undergoing caesarean section in a medical college for 2 years period.Methods: This is a prospective cohort study done over a 2 year period. Total 185 patients undergoing caesarean section and fulfilling medical eligibility criteria for PPIUCD were enrolled in the study. The followup of these patients was done at 6 weeks, 6 months and 1-2 years.Results: Thirteen patients (7%) lost to follow up so final outcome analysis was done in 172 patients. The problems encountered were spontaneous expulsion in 4 patients, removal due to heavy menstrual flow in 13 patients, non-visibility of threads in 4 patients, discharge per-vaginum in 1 patient and pain lower abdomen in 1 patient. Voluntary removal was done in 3 patients by 2 years who wished to conceive. The successful continuation rate came out to be 84.9% by 2 years. There was no failure reported in terms of intra-uterine or extra-uterine pregnancy and no increased risk of infection or perforation over the 2 years follow up.Conclusions: Immediate post-placental IUCD insertion is safe and effective method of contraception with no need to wait for 6 weeks which thereby reduces unwanted pregnancy rates. Mild discomfort and the minor post procedure complaints are taken care of well in puerperium. Higher rate of expulsion can be taken care of by early follow-up with regular visits and offering other safe and effective method of contraception.

scholarly journals Prospective study on outcomes of postpartum intrauterine contraceptive device including safety, efficacy and expulsion at GMERS Medical College, Dharpur-Patan, Gujarat, India

2018 ◽  
Vol 7 (8) ◽  
pp. 3131
Author(s):  
Parul S. Jani
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Prospective Analysis ◽  
Contraceptive Device ◽  
Tertiary Care Center ◽  
Hospital Record ◽  
Expulsion Rate ◽  
Medical College ◽  
Intrauterine Contraceptive ◽  
Post Placental

Background: Evaluation of PPIUCD in terms of incidence of failure, expulsion, bleeding p\v and other complication. Present study is aimed at determining the safety, efficacy, expulsion of post placental and intra cesarean insertion of intrauterine device.Methods: Prospective analysis was carried out to collect information regarding IUCD insertion and outcome at tertiary care center for the period of three years using the hospital record that a total number of 600 mothers had postpartum intrauterine contraceptive device.Results: Total women opted for PPIUCD 600, Followed up 560 after 1 week, 580 after 6 weeks and 400 after 6 months. Complications after 6 months 228. (pain 66, bleeding 37, expulsion 17, strings problem 7, discharge p/v 101).Conclusions: The insertion of PPIUCD is safe and effective method of contraception in the means of complication though it is a new concept for the population it is well accepted by the community though expulsion rate is somewhat high compare to conventional IUCD. it can be reduced with practice.

scholarly journals Comparative study of immediate post placental vaginal versus intra caesarean insertion of copper T380A

2018 ◽  
Vol 7 (8) ◽  
pp. 3158
Author(s):  
Rashmi Dhaduti ◽  
Sonali Deshpande ◽  
Shrinivas Gadappa ◽  
Nutan Wanjare ◽  
Sandeep Pund
Keyword(s):  
Normal Vaginal Delivery ◽  
Government Medical College ◽  
Medical College ◽  
Pain Abdomen ◽  
Significant Difference ◽  
Menstrual Disturbance ◽  
Post Placental ◽  
Lost To Follow Up ◽  
Postpartum Mothers

Background: The study was carried out to compare modes of PPIUCD that is safety, removal and expulsion rates of immediate post placental vaginal versus intracaesarean insertion of copper T380A.Methods: This was an interventional study conducted from January 2015 to December 2016 in Department of Obstetrics and Gynaecology, Government Medical College and Hospital, Aurangabad. This study involved participants who accepted PPIUCD in antenatal period and delivered in Government Medical College and Hospital, Aurangabad. Copper T380A was inserted vaginally after taking consent in 50 postpartum mothers within 10 minutes of normal vaginal delivery and 50 women who were undergoing caesarean section for obstetric indications who accepted copper T380A from contraceptive basket. Chorioamnionitis, prolonged premature rupture of membranes, unresolved postpartum hemorrhage, major medical disorder and participants who were lost to follow up were excluded. Antibiotic cover was given for 5 days. Participants were followed up either personally or telephonically at 6 weeks, 6 months or earlier if they had any complaints.Results: Among 50 post placental vaginally copper T380A inserted participants, 6(12%) had menstrual disturbance and pain abdomen each. One participant (2%) had infection vaginitis. Among 50 intracaesarean copper T380A inserted participants, 3 (6%) had menstrual disturbance and pain abdomen each. 6 (12%) had missing strings. Missing strings which was seen only in intracaesarean group was statistically significant when compared to post placental vaginal group. Expulsion was seen only in post placental vaginally copper T380A inserted participants (4 out of 50). There was no statistically significant difference in expulsion & removal rates of both the groups.Conclusions: Both modes of PPIUCD insertion were equally safe for participants except for missing strings which was seen more in intracaesarean group and was statistically significant.

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