A preliminary feasibility study to evaluate the safety, acceptability and efficacy of PPIUCD prior to implementation of PPIUCD service

Abstract

Introduction: PPIUCD is a very safe, reversible, long term contraceptive. The recommended interval between pregnancies is at least 24 months in order to reduce the risk of adverse maternal, perinatal and infant outcomes. In our district the usage of PPIUCD is 0.1% and 60% of deliveries take place in private health facilities. This preliminary study is conducted in a private teaching hospital with the aim to determine proportion of women accepting PPIUCD and to develop our own data regarding immediate complications to guide us in counselling the women and to implement PPIUCD services. Materials and Methods: This prospective feasibility study was done from July 2017 to January 2018. 100 women attending the for antenatal checkups were counselled for PPIUCD. The women who consented were inserted with PPIUCD. Results: Acceptance rate was 30% and most of the women who accepted PPIUCD were primiparae (58.3%). An analysis of the reasons for acceptance of PPIUCD showed that long term efficacy (33.3%), safety (20%), fewer clinic visits (16.6%) and non hormonal (13.3%) were the most common reasons for acceptance. Conclusion: The PPIUCD is safe having no reported incidence of perforation with low rate of expulsion, pelvic infection and few lost strings and these complications can be reduced further with training and practice. The acceptance and continuation rates can be improved with counselling and strategic follow up protocols in our district with very low rate of PPIUCD usage. Keywords: Postpartum intra uterine contraceptive device, Long acting reversible contraceptives, Acceptance, Complications.