Immediate Post-Placental Insertion versus Interval Insertion of Intrauterine Devices for Contraception

Authors

  • Rozina Mustafa
  • Haniyah Qamar
  • Khalida Nasreen

Abstract

Objective: To compare the frequency of uterine perforation, expulsion and pelvic infection rate of multiload 375 in women
of immediate post-placental (IPP) insertion versus interval insertion (I).
Materials and Methods: This Quasi-experimental study was carried out in the Department of Obstetrics & Gynecology, PNS
SHIFA Hospital Karachi from 6th October 2008 to 5th October 2009. Fifty patients were selected by consecutive sampling
technique for Group A (immediate post-placental insertion of multiload 375). Fifty women for group B (interval insertion of
multiload 375) were selected by simple random sampling during their postnatal follow-up visit. Post- insertion follow up visit
was done within six weeks. The results were analyzed by SPSS version 12 and expressed in frequencies and percentages.
Pearson’s Chi-square test was used as the test of significance.
Results: Mean age of women in group A was 29.02 ± 2.97 and in group B it was 31.24 ± 5.59 years. Multiparous women opted
for IUD in both groups (48% in group A versus 44% in group B). IUD expulsion was 14% & 18% in group A & B respectively.
While infection rate was 4% in group A and 2% in group B. Statistically non significant (P>0.05) results were found. No case
of uterine perforation was noted in both the groups.
Conclusion: Although both methods have almost same complication rate but for non compliant women IPP insertion of an
IUD is a convenient selection for contraception.
Keywords: Intrauterine device (IUD), Immediate

References

Elahi N, Koukab H. Diagnosis and management of lost intrauterine contraceptive device. JPMA 2002; 52: 18-21.

Ali R, Roohi M. Safety of IUCD (Copper-T380). Professional Med J 2002; 9: 44-52.

Saleem A, Kauser S, Tabassum S, Tajammal A. intrauterine Contraceptive Device in Pakistan: A study of 100 cases. Pak Postgrad Med J 2000; 11: 81-4.

Edwards DK. Dewhurst’s textbook of obstetrics & gyne-cology for postgraduates. 6th ed. Edinburgh: Blackwell Science, 2005.

Khawaja NP, Tayyeb R, Malik N. Awareness and practices of contraception among Pakistani women attending a tertiary care hospital. J Obstet Gynecol 2004; 24: 564-7.

Allen RH, Goldberg AB, Grimes DA. Expanding access to intrauterine contraception. Am J Obstet Gynecol 2009;201:456-9.

Penny G, Brechin S, de Souza A, Bankowska U, Belfield T, Gormley M, et al. FFPRHC Guidance: the copper intra-uterine device as long-term contraception. FamPlann Reprod Health Care 2004; 30: 29-41.

Department of Economic and Social Affairs, United Nations Statistics Division, United Nations. Retrieved July 30, 2010 from Millennium Development Goals indicators official site for United Nations’ MDG Indicatorswebsite: http://mdgs. un.org/unsd/mdg/Data.aspx

Mohamed SA, Kamel MA, Shaaban OM, Salem HT. Acc-eptability for the use of postpartum intrauterine contra-ceptive devices: Assiut experience. Med Princ Pract. 2003 Jul-Sep; 12(3):170-5.

Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009; 80:327–36.

Bonilla Rosales F, Aguilar Zamudio ME, Cazares Montero Mde L, Hernandez Ortiz ME, Luna Ruiz MA. Factors for expulsion of intrauterine device Tcu380A applied imme-diately postpartum and after a delayed period. Rev MédIn-stMexdelSeguro Soc. 2005; 43:5–10.

Chen BA, Hayes JL, Hohmann HL, Perriera LK, Reeves MF, Creinin MD. A randomized trial of postplacental compared to delayed insertion of the levonorgestrel relea-sing intrauterine device after vaginal delivery. Contra-ception 2009; 80: 205-9.

Grimes DA, Lopez LM, Schulz KF, Van Vliet HAAM, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2010; Issue 5 Art. No: CD003036.

Shukla M, Qureshi S, Chandravati. Post-placental intrau-terine device insertion - A five year experience at a tertiary care centre in north India. Indian J Med Res.012;136: 432–5.

Kumar S, Sethi R, Balasubramaniam S. Women’s experience with postpartum intrauterine contraceptive device use in India. Reprod Health. 2014;11:32. Doi: 10.1186/1742-4 755-11-32.

Ragab A, Hamed HO, Alsammani MA, Shalaby H, Nabeil H, Barakat R et al. Expulsion of Nova-T380, Multiload 375, and Copper-T380A contraceptive devices inserted during cesarean delivery. Int J Gynaecol Obstet. 2015;130(2):174-8. doi:10.1016/j.ijgo.2015.03.025. Epub 2015.

Erogul K, Akkuzu G, Vural G, Dilbaz B, Akin A, Taskin L,et al. Comparison of efficacy and complications of IUD insertion in immediate postplacental/early postpartum period with interval period: 1 year follow-up. Contraception 2006; 74: 376-81.

Caliskan E, Ozturk N, Dilbaz BO, Dilbaz S. Analysis of risk factors associated with uterine perforation by intrauterine devices. Eur J ContraceptReprod Health Care 2003;8:150-5.

Welkovic S, Costa L, Faundes A, Ximenes R, Costa C. Post-partum bleeding & infection after postplacental IUD insertion. Contraception. 2001; 63:155–8.

Singal S, Bharti R, Dewan R. Clinical outcome of Post-placental Copper T 380A insertion in women delivering by Cesarean section. J ClinDiagn Res. 2014;8(9):OC01-4.

Gupta S, Malik S, Sinha R, Mittal MK. Association of the position of the Copper T 380A as determined by ultrasonography following its insertion in the immediate post-partum period with the subsequent complications: An Observational study. J Obstet Gynaecol India. 2014;64(5): 349-53.

Lopez, Grimes, Szpir. (Family health international/CRTU programme). Immediate postpartum insertion of an IUD is safe & effective. Global health technical briefs. 2007. USA: USAID (United States Agency for International Development and Family Health International); 2007.

Afshan A, Shamim S A. Immediate postpartum IUCD (PPIUCD) insertion: an opportunity not to be missed. Ann Abbasi Shaheed Hosp Karachi Med Dent Coll. 2014; 19(1): 15-20.

Bhutta SZ, Butt IJ, Bano K. Insertion of intrauterine con-traceptive device at caesarean section. J Collhysicians Surg Pak. 2011;21(9):527-30.

Mishra S. Evaluation of safety, Efficacy and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). J Obstet Gynaecol India. 2014;64(5):337-43

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Published

2015-06-04

How to Cite

Mustafa, R. ., Qamar, H. ., & Nasreen, K. . (2015). Immediate Post-Placental Insertion versus Interval Insertion of Intrauterine Devices for Contraception. Journal of Bahria University Medical and Dental College, 5(2), 77–80. Retrieved from https://jbumdc.bahria.edu.pk/index.php/ojs/article/view/115

Issue

Vol. 5 No. 2 (2015): Volume 5 Issue 2

Section

Original Articles

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Copyright (c) 2015 Rozina Mustafa, Haniyah Qamar, Khalida Nasreen

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