Evaluation of safety efficacy and expulsion of postpartum and intracaesarean insertion of iucd (ppiucd)

In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective, long-term contraception such as intrauterine device (IUD) in post-partum women. The present study was planned to evaluate the safety efficacy and expulsion of immediate post-partum IUD insertion in women delivering vaginally or by caesarean section in a tertiary care centre facility in Rajah Muthiah Medical College and Hospital, Chidambaram during a period of two years.
Methods: The women recruited had CuT 380A insertion immediately after delivery of placenta in vaginal or caesarean delivery. Women having post-partum haemorrhage (PPH), anaemia, pre-labour rupture of membranes >18 h, obstructed labour and distorted uterine cavity by fibroid or by congenital malformation were excluded from the study. The women were followed up at 4 wk after delivery.
Results: A total of 75women were included in the study. Of these,66 (88%) came for first follow up. The cumulative expulsion rate at the end of 4weeks was 12.12 per cent. There was no case of misplaced IUD.
Interpretation & conclusions: Although the expulsion rate for immediate post-partum insertion was higher than for interval insertion, the benefits of providing highly effective contraception immediately after delivery outweigh this disadvantage, particularly in country where women have limited access to medical care.