Indian Journal of Health Sciences and Care

  • Year: 2021
  • Volume: 8
  • Issue: 2

Post-placental versus Interval Insertion of Intrauterine CuT Device: A Prospective Comparative Study

  • Author:
  • Kavita Khoiwal1, Divya Mishra2, Amrita Gaurav1, Ranjeeta Kumari3, Jaya Chaturvedi3
  • Total Page Count: 7
  • Page Number: 103 to 109

1Assistant Professor, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India

2Senior Resident, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India

3Associate Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India

Abstract

Immediate postpartum period is the ideal time to commence contraception as women are highly motivated and vulnerable to unwanted pregnancy at this time. The objective of this study was to compare the post-placental Intrauterine CuT device (IUCD) with interval IUCD in terms of acceptability, efficacy, and complications.

A prospective observational study was conducted for a period of one year (January 2019 to January 2020) at a tertiary care center in India. Sixty and thirty women were included in the postplacental and interval group respectively. Data was analyzed at the end of 1 year, 4 women in post-placental and 9 in interval group were lost to follow up.

Acceptability rate was high and comparable in both the groups (85.7% & 95.2%; p=0.25). Complication rate was similar in both groups (33.9% & 23.8%; p=0.39). The most frequent complication in the post-placental group was expulsion (14.2%), and heavy menstrual bleeding (9.5%) in the interval group. Multiparous women and who delivered vaginally had more risk of IUCD expulsion. Missing IUCD thread was seen exclusively in women who delivered by cesarean. Women who perceived ‘no pain’ during insertion were significantly higher in post-placental group than interval group (25% vs 0; p = <0.001). Overall satisfaction rate was similar and high (85.7% & 95.2%; p=0.58) in both the groups.

Post-placental IUCD is more convenient, equally safe, efficacious, and acceptable than interval IUCD. All women should be counseled in the antepartum period for post-placental IUCD particularly in underdeveloped and developing countries.

Keywords

Post-placental IUCD, Interval IUCD, Acceptability, Expulsion, CuT380A