scholarly journals Fetal evaluation of post partum intrauterine contraceptive device versus interval intrauterine contraceptive device insertion

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):  
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):  
Dolly Chawla ◽  
Puja Bharti ◽  
Menka Verma ◽  
Rashmi Khatri

Background: Worldwide, Intrauterine Contraceptive Device (IUCD) is one of the most commonly used reversible methods of contraception among married women of reproductive age. It is the second most commonly used forms of contraception, ranking second only to female sterilization. Proper positioning of Copper containing IUCD is of utmost importance for efficacy and safety. The immediate postpartum period, after a birth but prior to discharge from the hospital is an important but under utilized time frame to initiate contraceptives, specially long acting contraceptives such as intrauterine contraceptive device (IUCD). To study the location of Copper IUCD by ultrasound, relationship between position and complaints, failure rate and expulsion rate in post-partum IUCD cases.Methods: The study was prospective, analytical study conducted on 200 women for one year.  IUCD insertion was done in two groups; group A (normal delivery, postplacental) and group B (caesarean section, intracaesarean). On ultrasonography, position and distance of IUCD from fundus of uterus was measured. Outcome measures were expulsion, complication and failure rate upto six months. Informed consent was taken from each participant and ethical justification for the study was sought.Results: Majority of the patients were in age group of 21-25 years. Multigravidae patients had more acceptability of IUCD than primigravidae. More than half of IUCD insertion was done by senior residents (56%). Malpositions were more common in vaginal delivery (62%) than caesarean section (28%). Most common malposition was mid cavity and least common was oblique. Most common complaint was pain abdomen and least common was expulsion.Conclusions: Sonography can be used as an adjunct to clinical examination to examine the position of the IUCD. Ultrasonography done after PPIUCD insertion helps in determining, whether PPIUCDs are placed in normal position or malposition. Malpositioned PPIUCDs have more complications as compared to normally placed IUCDs


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.


2020 ◽  
pp. 8-10
Author(s):  
Biswajit Ghosh ◽  
Bharat Chandra Mandi ◽  
Dipa Mullick ◽  
Chaitali DattaRoy ◽  
Debarshi Jana

INTRODUCTION Contraception is one of the proximate determinants of fertility and the most important predictor of fertility transition. Contraceptive use helps couples and individuals realize their basic right to decide freely and responsibly if, when and how many children to have. The growing use of contraceptive methods has resulted in not only improvements in health-related outcomes such as reduced maternal mortality and infant mortality, but also improvements in schooling and economic outcomes, especially for girls and women. AIMS & OBJECTIVES Find out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. The complications of post placental &intra caesarean PPIUCD if any among these acceptors. Determine the spontaneous expulsion rate of this contraceptive device. MATERIALS AND METHODS Descriptive study with a longitudinal design. The present study was a hospital based study conducted at the department of Gynecology and Obstetrics department of the Institute of Post graduate Medical Education and Research (IPGMER) and SSKM. The study was conducted for a period of 18 months between April 2017 To September 2018. All 243 pregnant eligible women who delivered either by normal vaginal or instrumental delivery or caesarean section during the data collection period. RESULTS The above table shows that most of the participants enrolled in the study were in the age group of 21 - 25 years (39.9%), had completed secondary education (32.0%) and were housewives (74.2%), of urban residence (63.5%). About half of the participants were Muslim (49.4%), 47.2% were Hindus while 3.4% were Christians. SUMMARY AND CONCLUSIONS It can be concluded that PPIUCD is a promising new approach. Cu T 380A inserted in the post-partum period is both convenient and safe. The advantage of single visit insertion can be utilised to expand the usage of IUCD to meet the unmet needs of contraception.


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):  
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.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bekalu Getnet Kassa ◽  
Alemu Degu Ayele ◽  
Habtamu Gebrehana Belay ◽  
Adanech Getie Tefera ◽  
Gebrehiwot Ayalew Tiruneh ◽  
...  

Abstract Background The intrauterine contraceptive device, a type of long-acting reversible contraception, is one of the most effective and safe contraceptive methods. In Ethiopia, intrauterine contraceptive device is little known and practised to delay pregnancy. Therefore, this study aimed to assess post-partum intrauterine contraceptive device utilisation and its associated factors among women in Ethiopia. Method In the current meta-analysis, variables were searched from different electronic database systems, including PubMed, Google Scholar, EMBASE, HINAR, Scopus, Web of Sciences, and Grey literature. Data were extracted using a standardised data collection measurement tool. The data were also analysed by using STATA 16 statistical software. I2 tests assessed heterogeneity between the studies. A random-effect model was used to forecast the pooled utilisation of postpartum intrauterine contraceptive device. Results Twelve full-article studies were included. The pooled prevalence of post-partum intrauterine contraceptive device among women in Ethiopia was 21.63%. Occupation (OR = 4.44, 95% CI, 2.24–8.81), educational level of college and above (OR = 5.93, 95% CI, 2.55–13.8), antenatal care (OR = 2.09, 95% CI, 1.4–3.12), age (OR = 4.8, 95% CI, 2.3–10.04), good knowledge (OR = 4.16, 95% CI, 1.65–10.49), counseling (OR = 3.05, 95%CI, 1.41–6.63), husband support (OR = 11.48, 95% CI, 6.05–21.79) and awareness about IUCD (OR = 3.86, 95% CI, 1.46–10.2) were positively associated with utilization of postpartum intrauterine contraception device. Conclusions Utilisation of post-partum intrauterine contraceptive device was significantly low. Scaling up women’s educational status and ANC use has paramount importance in increasing post-partum IUD use, which further improves maternal and child health in general. This finding may be useful in both reproductive health promotion at an individual level and policy-making regarding this issue.


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