Comparative Evaluation of PPIUCD Insertion in Post Placental Vs within 48 Hours of Delivery

India is the second most populous country in the world after china. It has 16% of the world's population being supported by 2.5% of the land area only. For most women, getting an institutional delivery is the only time when a woman gets an opportunity to visit a health set up. Offering family planning could prevent many future unintended pregnancy.

The continuation rateand problems PPIUCD insertion in post placental vs within 48 hours od delivery

A Prospective study which was conducted in the Department of Obstetrics and Gynaecology, Subharti Medical College, Meerut, to compare Acceptability, Safety and Continuation rate of Copper T 380A during immediate post placental insertion vs. Insertion within 48 hours of delivery.

All women attending antenatal OPD and emergency clinic, in early labour and in post natal wards were counselled about the benefits of child birth spacing, small family and various options for immediate post-partum contraception were explained by cafeteria approach. The first 100 women who opted for immediate post placental IUCD insertion were included in Group A and the first 100 women who opted for post-partum IUCD within 48hrs were included in Group B.

Post placental insertion was done by using Kelly's forceps by standard technique.

The continuation rate was 96% at the end of 6 months of study. At each follow up visit, 22.5% women have reported pain in lower abdomen, 0.5% vaginal discharge, and irritation due to strings, personal problems, menstrual irregularities in 2%, weakness and thread coming out of vagina. visibility of strings was seen in 90% case by the end of study. They were examined and treated accordingly. Failure of contraception was reported in 1 patient. There was no case of perforation.

The PPIUCD is a safe method of contraception in immediate post placental insertion. The pain experienced by a women due to CuT380A is camouflaged with the after pains and hence leads to higher acceptance of the PPIUCD device. The PPIUCD does not cause menstural irregularities as the women is in lactationalamennorhoea. The main reason behind removal of CuT 380A was partial expulsion of the IUCD.