Clinical Outcome of Intra Caesarean Intrauterine Contraceptive Device Insertion

Abstract

Background: Intrauterine contraceptive devices (IUCDs) are considered as one of the safest and effective form of contraception. There are 128 million women users worldwide. We fall in those countries where unmet need of contraception is still high. Motivating women for intra caesarean copper T insertion can reduce the incidence of unplanned pregnancies. Postpartum intrauterine contraceptive device (PPIUCD) insertion is an effective, long-term, reversible, non-hormonal contraceptive and best suited for most women. This study was conducted to evaluate the long term complications like bleeding, pain, expulsion rate, perforation, infection and missing strings amongst the users. Objective: To determine the frequency of complications of intra - caesarean IUCD insertion. Methodology: This study was conducted in Lady Willingdon hospital, Lahore after approval of ethical committee. The non-probability purposive sampling technique was used. Informed consent was taken from all the patients. IUCD insertion was done under aseptic technique by the researcher. Women were advised to attend for follow-up after 6 weeks. Information was obtained about the complications of IUCD through a proforma that was same for all cases and the variables are listed under heading of operational definitions. Setting: Lady Willingdon Hospital Lahore, a Leading Tertiary Care Hospital Results: Total no of insertions in our study were 250 and they were followed for a period of 6 months. Mean age of the patients was 27.16 years. The patients who received PPIUCD with no previous baby was 14.8%, para one 18.4%, para two were 24.4% and 42.4% were with higher parity. Continuation rate was higher with 85.2% at the end of 6 months as compared to the expulsion rate of 14.8%. Bleeding was reported in 14 %, pain in 10% and infection in 18 % of cases. Missing strings were observed in 12% of cases. Removal rate after 6 months was 10%. Majority of the removal were due to infection 5% followed by planning a pregnancy in 3%. Pain was the cause for removal in only 0.5% and bleeding in 0.5% cases. Conclusion: Intra caesarean IUCD insertion was concluded to be a safe and effective method of contraception for spacing with high continuance rate, low expulsion and complication rates.