Abstract

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.