Outcomes of Immediate Postpartum Intra-Uterine Contraceptive Device (PPIUCD) Insertion in a Military Based Hospital

Abstract

Aim: To determine the outcomes of post-partum IUCD (PPIUCD) in early post-partum period in females delivering by cesarean section or vaginally. Methods: We conducted this quasi-experimental study in PAF Base Faisal hospital Karachi within a duration of 14 months from April-2017 to June-2018. A total of 500 females of PPIUCD insertion after either vaginal or Csection delivery were selected for this study. We used CuT-180 IUCD device in all cases. In females having vaginal delivery, IUCD was placed in the uterine fundus using Kelly’s Placental Forceps after ten minutes of placenta removal. In C-section patients, IUCD was placed directly in the uterine fundus. Results: Mean age of studied females was 28.47+8.51 years. PPIUCD was inserted in 345(69%) females having simple vaginal delivery (SVD) and 155(31%) having C-section. Regarding outcomes, IUCD expulsion was noted in 29(5.8%) females, 21(6.08%) in SVD and 8(5.16%) in C-section patients (p-value 0.68). Malposition of device occurred in 5(1%) females, 3(0.86%) in SVD and 2(1.29%) in C-section (0.66). Vaginal discharge was reported by 81(16.2%) females, 54(15.65%) in SVD vs 27(17.41%) in C-section patients. Menstrual problems were reported by 89(17.8%) females, 58(16.8%) of SVD and 31(23.22%) of C-section females (p-value 0.38). Removal of IUCD was done in 37(7.4%) cases, 28(8.1%) in SVD patients and in 9(5.8%) cases in whom IUCD was inserted after C-section (p-value 0.36). Conclusion: PPIUCD is an effective and safe technique of contraception. It has minimal complications rate. Government should emphasis on counseling of families regarding IUCD in early post-partum period to increase awareness regarding its beneficial effects.