Incidental retained intrauterine Lippe’s loop in 65 years old woman: a rare case report

Intrauterine contraceptive devices are a widely used method of contraception. It is cheap, easy and an effective method. The first intrauterine device was Lippe’s loop which was double S shaped trapezoid loop introduced in 1962. Nowadays, third generation intrauterine devices are used which are effective for 5 and as well as 10 years. Here we presented a rare case of first generation of intrauterine device, that was, Lippe’s loop in a 65 year old lady which was found as an incidental finding. Intrauterine device insertion without the knowledge of women can lead to the forgotten device which can adversely affect the health of women.

Misplaced intrauterine contraceptive devices: a case report

Contraception is a new topic gaining attention in country like India and a new proposed area of research. Intrauterine contraceptive devices (IUCDs) are one contraceptive method requiring less efforts and having more efficacy. ‘Misplaced IUCD’ is one of the rare and the most dreadful complication of IUCD insertion. Clinically, it can present as having pain, bleeding, recurrent pregnancy loss or can be asymptomatic. This is a case report of a 40 year old P4A1L4 female who presented to us with suspicion of misplaced IUCD without clinical symptoms. Clinical examination and radiological investigations made a diagnosis of misplaced IUCD and laparoscopy confirmed it. Laparoscopically misplaced IUCD was removed.

Prevalence of Complications after Interval Postpartum Intrauterine Device Insertion

Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion

STUDY OF KNOWLEDGE ATTITUDE AND ACCEPTANCE OF PPIUCD IN ANTENATAL PATIENTS

Objectives: To nd out the knowledge, attitude and acceptance of postpartum intrauterine contraceptive devices (PPIUCD) among antenatal mothers. Methodology: This is an observational study conducted in MMCH medical college Muzaffarnagar to assess knowledge, attitude and acceptance regarding PPIUCD by antenatal mothers with family members by pre counseling and post counseling questionnaire. Results: A total of 120 antenatal mothers were studied from September 2020 to December 2020. Number of primi and multigravida were almost same in the study. Prior acceptance regarding PPIUCD was only in 15.0%. About 44.16% accepted for PPIUCD after counseling. Most common reason in 50.74% for non acceptance was fear of complications. Conclusion: Knowledge on PPIUCD of our antenatal mothers is poor. Counseling of antenatal women and their families is helpful for high acceptance of PPIUCD.For these women, the only opportunity to receive information about contraceptives is during childbirth when they are in contact with medical personnel. Hence, it is suggested that family planning should be integrated with maternal and child-care services in order to effectively promote the use of contraceptive devices in these women who otherwise would not seek the use of such a device.

Assessment of intention to use postpartum intrauterine contraceptive device and associated factors among pregnant women attending antenatal clinics in ambo town public health institutions, Ethiopia, 2018

Background Maternal mortality tragedy is the issue of both developed and developing countries, especially sub-Saharan Africa including Ethiopia, which is due to poor quality of maternal health care services. Therefore family planning especially the use of Postpartum intrauterine contraceptive devices can tackle unintended pregnancy and maternal death. However,the intention to use PPIUCD and the use of IUCD in general is not well practiced in Ethiopia according to evidences of the literatures. For this reason, many mothers are exposed to unintended pregnancy and pregnancy related complications. The main purpose of the study was to assess the intention to use Post-partum intra uterine contraceptive devices and its associated factors among pregnant women attending Antenatal Clinics in Ambo Town Public Health Institutions, Ethiopia, 2018. Methods A facility-based cross-sectional study design was conducted from March – April 2018 to assess the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors in 422 pregnant women. Study subjects were selected using systematic random sampling. Data were collected by structured questionnaire, entered into a computer using Epi-info 3.5.4 statistical program, and exported to SPSS version 20 for analysis. A Logistic regression model was used to predict the intention of pregnant women about Postpartum intrauterine contraceptive devices and associated factors. Lastly, a significant statistical association was tested using 95% confidence interval (CI) and p value (p < 0.05). Results The response rate was 417 (98.3%) and this study showed that 145(34.9%) of pregnant women intended to use Postpartum intrauterine contraceptive device. Age of pregnant women [AOR = 8.348(CI: 3.602–19.347], educational level [AOR = 3.249(1.057–9.985)], occupational status [AOR = 4.101(CI: 1.788–9.405)], monthly income [AOR = 3.175(CI: 1.423–7.082)] and knowledge [A0R = 5.408(2.994–9.767)] have shown significant associations with intention to use Postpartum intrauterine contraceptive devices. Conclusions The study found that 34.9% women intended to use PPIUCD. Maternal age, maternal educational level, occupational status, monthly income and knowledge were significantly associated with pregnant women intention to use PPIUCD.

Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study

Introduction. Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective. Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods. An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results. Completing secondary education (AOR = 4.5, 95%CI 2.3–8.85), having a total number of children of 3–4 (AOR = 3.6, 95%CI 1.25–10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5–15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44–5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7–16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99–12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3–4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.