Comparative study of immediate post placantal versus interval IUCD (CuT 380A Insertion)

Abstract

Introduction: Unintended pregnancy is still a major concern in India. It can be only prevented by effective contraceptive measures especially if it is used in postpartum period as it is highly vulnerable period to unintended pregnancy. The immediate postpartum period, after birth but before discharge from hospital is an important but underutilized time frame to initiate contraceptives specially long acting contraceptives like intrauterine contraceptive device. The study was conducted to evaluate the efficacy, side effects, continuation rates, and reasons for removal along with effects of expertise on complication rate between post partum IUCD, intra cesarean IUCD and interval IUCD insertion. Materials and Methods: study was prospective randomized conducted on 300 women for one year. IUCD insertion was done in three groups; group A (post-placental), group B (intra cesarean), group C (interval IUCD). All the groups were evaluated and compared with respect to the efficacy, side effects, continuation rates, and reasons for removal along with effects of expertise on complication rate Results: Most of women were of middle socioeconomic status and second gravida of age group 25-30 years of age. In all groups overall continuation rate after 6 weeks of insertion, 6 month and one year was 56.7%, 51.7% and 51.7% respectively. Complication rates are more after 6 weeks than 6 months and 1 year. Most common reason for removal was missing threads (16%).Complications needing removal were less when inserted by consultants than residents. Conclusions: We concluded that IUCD (Cu T 380 A) is an effective and safe reliable long term, reversible and convenient method of contraception which if properly implemented can help the unmet need of contraception to a greater extent even in postpartum period. Keywords: Intrauterine contraceptive device, Postpartum, Interval, Intra cesarean, Complications.