scholarly journals THE EFFECTIVENESS OF INSERTION OF IMMEDIATE POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE (IPP-IUCD) IN TERMS OF MODES OF DELIVERY

2020 ◽  
Vol 28 (4) ◽  
pp. 367-371
Author(s):  
Qudsia Qazi ◽  
Nazia Liaqat ◽  
Shehzadi Saima Hussain ◽  
Saima Khattak
Keyword(s):  
Abdominal Pain ◽  
Vaginal Delivery ◽  
Vaginal Bleeding ◽  
Intrauterine Contraceptive Device ◽  
Normal Vaginal Delivery ◽  
Contraceptive Device ◽  
Normal Delivery ◽  
Significant Difference ◽  
Intrauterine Contraceptive

BACKGROUND: Family planning helps couples to attain their desired number of children and proper timings of their births (1). It is best achieved with different contraceptive methods. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is an excellent contraception providing safe, effective and long term reversible contraception in women after both normal delivery and c/section(2). It reduces postpartum undesired pregnancies and thus induced abortions (3). It is coitus independent, easy to insert and does not affect breastfeeding. Both care provider and client are available in the same setting, securing time and cost of interval IUD insertion.  PPIUCD is associated with primary complications like pregnancy and secondary ones as irregular vaginal bleeding, abdominal pain, infection, expulsion and uterine perforation. PPIUCD counselling services regarding its common side effects and complications are important. There is minimal research comparing follow up outcomes between vaginal and caesarean insertions. The objective of study is to compare outcomes of IPPIUCD as a factor of route of insertion. METHODS: In this prospective comparative study 200 patients in whom postpartum IUCD was inserted within 10 minutes of delivery of placenta after normal vaginal delivery or c/section were included. About first 100 cases of vaginal and first 100 cases of intra-cesarean PPIUCD insertions formed study groups. Record of clients was maintained and analysis at 6 weeks to 12 weeks post insertion follow up visit was done at gynae and obstetric unit of Lady Reading Hospital Peshawar. RESULTS: Of total 1005 IPPIUCD inserted during the study period, about 156( 15.5%) were inserted intra-cesarean and 849 (84.4%) after vaginal delivery. Follow up of 200 (19.9%) clients i.e. about 100 intra-cesarean and 100 vaginal insertions was recorded. Complications rate was low. No life threatening complication such as perforation was recorded. Most common complications observed between vaginal vs intra-cesarean insertions were irregular vaginal bleeding in (11% vs 5%), abdominal pain(6% vs 9%), vaginal discharge(8% vs 5%),spontaneous expulsions  (8% vs 2%) and lost strings (14% vs 1%). Statistically significant difference was found between two groups with respect to lost strings (P=0.0006). CONCLUSION: IPPIUCD is an acceptable, safe (in terms of complications) and effective contraceptive option after both vaginal and intra-cesarean insertions. Early follow up examinations are helpful in identifying spontaneous expulsions and dealing common problem.

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 Immediate Postpartum Intrauterine Contraceptive Device Insertions in Caesarean and Vaginal Deliveries: A Comparative Study of Follow-Up Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Reetu Hooda ◽  
Sonika Mann ◽  
Smiti Nanda ◽  
Anjali Gupta ◽  
Hemant More ◽  
...  
Keyword(s):  
Family Planning ◽  
Tertiary Care ◽  
Intrauterine Contraceptive Device ◽  
Categorical Variables ◽  
Contraceptive Device ◽  
Complication Rates ◽  
Vaginal Deliveries ◽  
Significant Difference ◽  
Intrauterine Contraceptive

Background. Immediate postpartum intrauterine contraceptive device (IPPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim was to study the clinical outcomes of IPPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean).Methods. This is a retrospective analytical study done in a tertiary care teaching institute. A Cohort of 593 vaginal and caesarean deliveries with IPPIUCD insertions, over a two-year period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings. Descriptives were calculated for various outcomes and chi square tests were used for comparison in between categorical variables.Results. Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 5.3% cases and were significantly higher in vaginal insertions (p=0.042). The incidence of undescended strings was high (38%), with highly significant difference between both groups (p=0.000).Conclusion. IPPIUCD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.

scholarly journals Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Waqas Hameed ◽  
Syed Khurram Azmat ◽  
Moazzam Ali ◽  
Wajahat Hussain ◽  
Ghulam Mustafa ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Contraceptive Usage ◽  
Social Franchise ◽  
Intrauterine Contraceptive ◽  
Contraceptive Discontinuation

Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant.Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion.Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

2021 ◽  
pp. 1-3
Author(s):  
Shweta Pathak ◽  
Manaswita Samanta ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Contraceptive Device ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

scholarly journals Endoscopic removal of an incidentally discovered intrauterine contraceptive device eroding into the rectum

2019 ◽  
Vol 12 (9) ◽  
pp. e231410
Author(s):  
Mahdi Abdulrasoul Al Sahaf ◽  
Bahaa Farouk Bseiso ◽  
Sami Abdulmohsin Al-Momen ◽  
Abdul-Wahed Nasir Meshikhes
Keyword(s):  
Control Method ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Birth Control Method ◽  
Endoscopic Removal ◽  
Rectosigmoid Colon ◽  
Diagnostic Colonoscopy ◽  
Intrauterine Contraceptive ◽  
Pelvic Viscera

Intrauterine contraceptive device (IUCD) is a common birth control method. It is safe but can be associated with serious complications including migration into the peritoneal cavity and penetration into other intra-abdominal and pelvic viscera; most commonly the rectosigmoid colon. Different retrieval methods including endoscopy, laparoscopy or open abdominal surgery have been described. We report the case of 38-year-old woman who became pregnant shortly after insertion of the IUCD 6 years prior to presentation. She delivered vaginally and ‘expulsion’ of the device was assumed. Some 4 years later, she had another IUCD inserted and remained asymptomatic till she recently presented with iron-deficiency anaemia. As part of the investigation, diagnostic colonoscopy was performed. Surprisingly, the old IUCD was found penetrating into the midrectum. Uneventful endoscopic removal was performed and she remained well at 3-month follow-up. Migrating IUCD remains asymptomatic and may be discovered accidentally during routine investigation for some other symptoms.

scholarly journals Immediate post placental insertion of intrauterine contraceptive device at caesarean delivery: a prospective study

2020 ◽  
Vol 9 (6) ◽  
pp. 2244
Author(s):  
Sravani Mukka ◽  
Madhavi Y.
Keyword(s):  
Family Planning ◽  
Prospective Study ◽  
Post Partum ◽  
Unmet Need ◽  
Intrauterine Contraceptive Device ◽  
Efficacy Rate ◽  
Contraceptive Device ◽  
Intrauterine Contraceptive ◽  
A Prospective Study

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.

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