A Prospective Study to Evaluate Vaginal Insertion and Intra-Cesarean Insertion of Post-Partum Intrauterine Contraceptive Device

J Obstet Gynaecol India. 2016 Feb;66(1):35-41. doi: 10.1007/s13224-014-0640-2. Epub 2014 Dec 14.

Abstract

Objectives: Evaluation and comparison of safety and efficacy of vaginal and intra-cesarean insertion of Post-Partum Intrauterine Contraceptive device (PPIUCD).

Methods: An interventional prospective study conducted in the Department of Obstetrics and Gynaecology at NRS Medical College, Kolkata. PPIUCD were inserted in 263 mothers in 1-year study period. Among them, first 100 mothers who delivered vaginally and the first 100 who underwent cesarean section were regarded as study groups and were followed up for 1 year.

Results: Both modes of PPIUCD insertion were found to have very low rates of expulsion, vaginal bleeding, infection, missing strings, and also effective as contraceptive. Expulsion rate was 4 % in the vaginal group and 2 % in intra-cesarean group. Strings of PPIUCD were less visible after cesarean insertion than vaginal insertion (p = 0.028).

Conclusion: PPIUCD is an appealing approach and may become the best choice as post-partum contraception after vaginal as well as cesarean delivery.

Keywords: Immediate post-partum; Intra-cesarean insertion; PPIUCD; Vaginal insertion- post-placental.