The effectiveness of insertion of immediate postpartum intrauterine contraceptive device (Ipp-iucd) in terms of modes of delivery

Abstract

Objective: The objective of the study is to compare the effectiveness of IPP-IUCD in terms of mode of delivery Methods: This observational study was conducted at Gynaecology and Obstetrics units of Lady Reading Hospital Peshawar of Khyber Pakhtunkhwa, Pakistan, where 200 patients, in whom postpartum IUCD was inserted within 10 minutes of delivery of placenta after normal vaginal delivery (group 1) or c/section (group 2), were included. These patients were grouped into 100 cases of vaginal and 100 cases of intra-cesarean IPP-IUCD insertions. Record of follow up of these 200 (19.9%) patients was maintained and analyzed at 6 weeks to 12 weeks` post-insertion follow up visits. Results: No life-threatening complications such as perforation was recorded in both groups. 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: IPP-IUCD 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.