Online ISSN: 2515-8260

Keywords : PPIUCD


A cross sectional study on acceptability, safety and evaluation of post-vaginal delivery and intra-cesarean insertion of PPIUCD at tertiary Centre

Dr. Prathibha SD, Dr. Shreya Mallesh, Dr. Anitha N, Dr. Santosh S Basarakod, Dr. Ullas Mahesh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 5, Pages 400-406

Introduction: India is world’s second most populated country with nearly 20.7% of the Indian population have unmet needs for family planning with 65% in the first year of postpartum period. Postpartum period is the ideal time of family planning studies as spacing less than two years of child birth can lead to obstetric complications and maternal mortality. Hence practice of contraception is mandatory.
In this study we have emphasised Cu375insertion which has the advantage of high motivation, safety and convenience for both patients and the service provider. Here we conducted a pilot clinical study comparing intra-caesarean Cu375 insertion and post-placental insertion following vaginal deliveries.
Materials and Methods: A systematic study with 60 patients in each group recruited clients randomly based on acceptance and mode of delivery. Group A intra-caesarean insertion and Group B post- placental insertion following vaginal deliveries. The cases were followed up at 6weeks and 6months post-insertion with a set of parameters. Here we look for Missed strings, Expulsion and Infection rate as the primary outcome measures. Complications as the secondary outcome measures.
Results: Infection rate is found to be higher in Group B(5%) than Group B at 6th week. At 6th month, infection is higher in Group B (1.8%) than Group A(0.9%) p=0.617. Missed strings are found to be higher in intra-caesarean than interval method both at 6th week and 6th month follow up. Expulsion rate is found to be higher in Group B(3.3%) than Group B(1.67%) p=0.5 at 6th week. At 6th month there is no IUCD expulsion in Group A (0%) than in Group B where there is (1.9%) expulsion p=0.497. Uterine perforation noted among 3.35% in group A compared to 1.67% in group B. There is no complications or contraceptive failures in both groups during the study period. On statistical analysis, it is found that there is no significant difference in infection and expulsion rate between the groups. For missed strings there is a significant difference between the groups with more missed strings in intra-caesarean method.
Conclusion: To conclude that, intra-caesarean method is equally effective as interval
method without any added complications for contraception in caesarean deliveries, with added advantage of high motivation, good compliance and safety and easy for provider to deliver the services.

Post-partum intrauterine contraceptive device practices, its acceptance and outcome in a tertiary care hospital: A record based study

Niveditha R, Manohar Rangaswamy, Sandyashree PK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 858-864

Background: Only 26% of women are using any method of family planning in the first year
postpartum. Studies indicates that unmet need for family planning in postpartum period is as
65% (USAID ACCCESS 2009). Recent studies estimate that prevention of unplanned and
unwanted pregnancies could help avert 20 – 35% of maternal deaths and as many as 20% of
infant deaths. Use of temporary contraceptives in our country is limited to 10.2% and that of
intrauterine contraceptive device (IUCD) is only1.8%. Post-Partum IUCD (PPIUCD) was
thus introduced in the National Family Planning Programme, India in 2009-10.
Methods: This is a Retrospective study conducted in department of obstetrics and
Gynaecology, Mandya Institute of Medical Sciences, Mandya. All deliveries during time
period from April 2018 to March 2021 were included in the study. Women accepting
PPIUCD were analysed with respect to age, parity, educational status, complaints (during the
follow up visits) and timing of insertion.
Results: Out of total 31,212 deliveries between April 2018 to March 2021.19,662. delivered
vaginally, 11,550 delivered by C section. 702 (2.24%) accepted PPIUCD as a method of
contraception. Intra cesarean insertion were 567 cases, Post placental insertion were 108
cases and immediate postpartum insertion 27 cases. 54% of users were of age group 20 -
25yrs, 53.8% were Primipara. Most common complication reported was bleeding PV in about
5. 9% and 6.4% discontinued PPIUCD due to sexual interference [2.99%] as the commonest
reason.
Conclusion: Less acceptance of PPIUCD services in our hospital reminds us to optimize
PPIUCD services by counseling pregnant women right from ANC visits. Education and
counseling can plays major role in acceptance and IUCD continuation rate. Obstetricians and
nursing staff should play a major role to dispel myths and misconceptions prevalent with
IUCDs.

OUTCOME OF INTRA-CAESAREAN PPIUCD INSERTION

Dr. Bhakti kalyankar, Dr. Vijay kalyankar, Dr Shrinivas Gadappa, Dr Saleha kausar, Dr Harshita S .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2613-2621

Aim of study: To study the acceptance rates of intra-caesarean Post placental Intrauterine contraceptive device insertion and to assess the safety , efficacy , expulsion rates , continuation rates and complications related to intra-caesarean PPIUCD insertion
INTRODUCTION : This study examines the factors responsible for accepting the intra-caesarean PPIUCD insertion and evaluates the safety,  efficacy,  expulsion and continuation rates of intra-caesarean PPIUCD insertion.
Material & Methods: This  Prospective observation study was conducted in at Depatment of Obstetrics and Gynecology Goverment Medical College Aurangabad tertiary care hospital conducted from November 2019 to October 2021. In present study we have enrolled 332 cases during two years. Women fulfilling the inclusion criteria underwent postpartum insertion of IUCD.
Observation & Results: There were no major complaints in either group in Post operative period . At 6 months follow up in PPIUCD users, 3.91% had spontaneous expulsion and 4.21% removed copper T due to various reasons , 95.05% continued to use this method . There were no complications like perforation of uterus, intrauterine pregnancy with copper T, extra uterine pregnancy and infection.
Conclusion: The intra-caesarean PPIUCD insertion was found safe with low rates of expulsion, minimal bleeding tendencies, negligible rate of infection. PPIUCD looks promising as a first choice contraceptive in the eligible ones as a long term, reversible contraceptive in the control of health care , coitus independent,  no interference with breastfeeding and without any systemic side effects.

A study to assess the safety, efficacy of PPIUCD in a tertiary care centre in a hilly region of South India

Dr. Sowmya D, Dr. Somashekar HK, Dr. Salma Shaziya, Dr. Sowjanya D, Dr. Harsha TN, Dr. Pradhyumn GK

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2162-2168

Background: In India 65% of women have unmet need for family planning during the first year post-partum, Insertion of PPIUCD appears appealing because, High unmet need for contraception during the first post-partum period, increasing rate of institutional delivery, Long term and reversible method, it requires only once motivation, Highly effective, Long-term benefits of reducing maternal mortality burden, hence in recent past PPIUCD as a method of contraception has evolved.
Objectives: To assess the safety and efficacy of PPIUCD.
Materials and methods: This is an observational study from June 2019 to May 2020, conducted in department of OBG, Kodagu Institute of Medical Sciences to assess the safety and efficacy of CuT380A when inserted within 10 mins of placental expulsion up to 48 hours after delivery. During this period total number of deliveries were 3293. Among them 833 women had PPIUCD insertion. Counselling of PPIUCD was done during their antenatal visit, early labour, immediate postpartum and while preparing for the scheduled caesarean delivery. Post-abortal and 6 weeks postpartum IUD insertion were excluded from study.
Results: Of 3293 total deliveries, women who had PPIUCD insertion were 833(25.9%). Among them Post placental 165(19.8%), Primary cesarean delivery 550(66%) and repeat cesarean delivery 24(2.88%). PPIUCD counselling were done during antenatal period in 211 (25.3%), during early labor in 528 (63.3%) and during postpartum period 94 (11.2%). Acceptance of PPIUCD insertion was found to be 526(63.14%) among women of age 20-25 years, primipara 651(67.34%), who had at least primary education 249(29.9%). 812 women attended follow up. 651(80.17%) had no complaints, continued counselling helped. Complications like string problem (5.91%), expulsion rate (2.83%), pain abdomen (6.4%), bleeding P/V (3.94%). PPIUCD was found to be safe as there was no evidence of perforation or failure rate. 10 women insisted for removal of PPIUCD, one of the main reasons was social factor.