Follow Up & Outcome Assessment in Patients with Postpartum IUCD Insertion for Birth Control

Abstract

Introduction: India is world’s 2nd largest populated country. It is first to introduce family planning services. IUCD is most effective, safe, long acting and do not interfere with coitus. Postpartum intrauterine contraceptive device (PPIUCD) is a lucrative postpartum family planning method which provides effective reversible contraception to women in the delivery setting. Our aim is to study the clinical outcomes of PPIUCD insertions and compare them as a factor of route of insertion (vaginal versus caesarean).
 Method: This is a prospective analytical study done in a tertiary care teaching institute. A total of 180 vaginal and caesarean deliveries with PPIUCD insertions, over 8 months period, was studied and compared for follow-up results. Outcome measures were safety (perforation, irregular bleeding, unusual vaginal discharge, and infection), efficacy (pregnancy, expulsions, and discontinuations), and incidence of undescended IUCD strings.
 Results: Overall complication rates were low. No case of perforation or pregnancy was reported. Spontaneous expulsions were present in 4.4% cases and were significantly higher in vaginal insertions. The incidence of undescended strings was high (30%), with highly significant difference between both groups.
 Conclusion: PPIUCD is a strong weapon in the family planning armory and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.