Evaluation of Safety, Efficacy and Continuation Rates of Postpartum Intrauterine Contraceptive Devices (PPIUCD)

BACKGROUND : Family planning with adequate spacing between the pregnancies can prevent about 32% of maternal deaths and 10% of child mortality. Pregnancies with less than the recommended spacing are associated with increased maternal as well child mortality and morbidity. Among the options available, the multi-year cost of Cu T 380A makes it one of the most cost effective contraceptive available. AIMS AND OBJECTIVES : To evaluate the safety, efficacy and continuation rates of postpartum intrauterine contraceptive devices (PPIUCD). METHODOLOGY : This is a prospective study done at the Department of Obstetrics and Gynaecology, Coimbatore Medical College Hospital from August 2014 to July 2015. After obtaining informed consent, 200 women who fulfilled the inclusion criteria underwent postpartum insertion of Cu T 380A. They were followed up at 6 weeks, 3 months and 6 months postpartum. RESULTS : Out of the 200 women who underwent PPIUCD insertion (41.5% post placental, 20.5% immediate postpartum and 38% intracaesarean), majority of them were aged between 21-25 years (51.5%), most of them had studied up to middle school (29.5%), 95% were housewives, 54% of them belonged to lower socioeconomic status, 77% were para 1, 78.5% had 1 living child. The gross cumulative expulsion, removal and continuation rates were 5%, 6% and 78.5%. There were no cases of perforation, pelvic infection, pregnancy with IUCD in situ or other major complications noted. CONCLUSION : PPIUCD is a safe, very effective, long acting contraception with few side effects and no major complications. Although the expulsion rates are high when compared to interval insertion, PPIUCD provide an effective contraception in countries with limited access to health care personnel