Enhancing contraceptive usage by post-placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy, and expulsion

Abstract

Abstract More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. Objective The study was conducted to assess the safety incidence of perforation/pain/bleeding/foul discharge and expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of placental expulsion both in vaginal and caesarean section deliveries. Methods This was an open label, prospective, and longitudinal study. The study was approved by the Ethics Committee of FOGSI. Results The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS Hubli was easy in 99.52% of subjects after normal delivery, and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76% to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusion Inserting CuT 380 A at 10 minutes after placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.