Experience on Safety, Expulsion, and Complication of Intracesarean Post-Partum Intrauterine Copper Device

Abstract

Background The post-partum period is one of the critical times when ovulation is highly unpredictable and couples often underestimate the likelihood of pregnancy. According to the World Health Organization, intrauterine copper device (IUCD) can be inserted within 48 hours post-partum, referred to as post-partum IUCD (PPIUCD). The objectives of the present study were to determine the safety and expulsion of intracesarean PPIUCD. This study also has an objective to determine the complications (undescended/missed thread, bleeding, pain, and infection) following intracesarean PPIUCD insertion among the women. Materials and methods This was a prospective interventional hospital-based study conducted in the Department of Obstetrics & Gynecology, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India, from November 1, 2016, to October 31, 2019. Women were followed up at six weeks and six months for various objectives. Results Intracesarean PPIUCD was inserted in a total of 1,586 patients, and 1,029 cases came for follow-up at six weeks and six months; thus, the concluded sample size was 1,029. The majority of patients were of 20 to 25 years of age, belonged to rural areas, and were having parity 2. The most common complaint was of undescended/missed thread in 22.2% women followed by bleeding (11.9%), expulsion (2.2%), pain (2%), and local infection (1.3%) at six weeks follow-up. At six months, the most common complaint was missed thread in 8.6% followed by bleeding (6.0%), pain (1.6%), expulsion (1.2%), and local infection (0.7%). There was no case of perforation. While 19.05% women wanted the removal of PPIUCD, but at the end of the study period, it was removed in a total of 11.27% cases due to various reasons. Conclusions PPIUCD is an effective tool to reduce the unmet need of contraception. This study showed that most of the women were satisfied with the intracesarean insertion of IUCD, indicating its important place within the basket of post-partum family planning methods.