Intrauterine contraceptive device use in Abakaliki, southeast Nigeria: A 5-year review

Abstract

Objective: To evaluate intrauterine contraceptive device (IUCD) use in Abakaliki for acceptance rate, efficacy, and complications. Materials and Methods: A descriptive retrospective study was done in the family planning unit of the Federal Teaching Hospital, Abakaliki, between 1 January 2009 and 31 December 2013. The records of the clients from the family planning and their case files from the medical records units were studied. Data on sociodemographic characteristics, side effects, discontinuation, and reasons for discontinuation were extracted and fed into the computer using Epi Info program (2008) of Centers for Disease Control and Prevention (CDC) (Atlanta, GA) version 3.5.1 and were analyzed. Results: Out of 1,737 contraceptive acceptors, 230 clients accepted IUCD giving a rate of 13.2%. The mean age and parity were 33.6 ± 6.5 years and 4.6 ± 2.4, respectively. Only 3 (1.3%) out of the 230 acceptors were nulliparous, the rest were parous. Sixty eight clients discontinued the method giving a discontinuation rate of 29.6%. Young, married clients with low parity discontinued the method commonly desiring further conception hence used the method as spacer. The commonest reason for discontinuation was pregnancy desire (54.4%) followed by presence of side effect (19.1%). Eighteen clients (7.8%) had side effects or complications resulted from the use of this device. The commonest side effect was abdominal pain 8/18 (44.4%). Others were menorrhagia 4/18 (22.2%), missing IUCD 3/18 (16.7%), and pelvic inflammatory disease (PID) 3/18 (16.7%). The presence of side effect ( P = 0.0156) and occupation ( P = 0.0218) are the variables with significant correlation with the duration of usage of the method while young age ( P = 0.0009), low parity ( P = 0.0001), and marital status ( P = 0.0001) had statistically significant relationship with the discontinuation of the method. Conclusion: IUCD is very effective but with the acceptance rate of 13.2% among the methods offered and discontinuation rate of 29.6% in Abakaliki.