European Journal of Molecular & Clinical Medicine

Abstract

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.