A COMPARISON OF INTRACAESARIAN VERSUS INTERVAL PLACEMENT OF INTRAUTERINE CONTRACEPTIVE DEVICE

Abstract

Objective: To compare intracaesarian placement of intrauterine contraceptive device (IUCD) with interval placement at 6 weeks in terms of device expulsion and continued use at 6 months postpartum.

Study design: Randomized controlled trial.

Setting: Obstetrics and Gynecology Department, Combined Military Hospital Jhelum, Oct 2017 to Oct 2018.

Materials and methods: 104 pregnant women aged 20 to 40 years old, planned for an elective caesarian delivery and who opted for an IUCD were included. They were randomly divided into two equal groups using lottery method. Women were told about their assigned timing of IUCD placement well before their surgery. Group A had IUCD placed during caesarian section while group B (serving as controls) had insertion after 6 weeks. Cu-T 380 A was provided free of charge to all participants. Women were seen after 6 weeks, 3 months and 6 months. Both groups were analyzed and compared in terms of IUCD expulsion and continued use at 6 months postpartum.

Results: The device was placed in 48 women in group A and 35 women in group B (p 0.001). There was no statistically significant difference in device expulsion rates between the two groups (p 0.37). After 6 months significantly higher proportion of women in the intracaesarian group were continuing to use the IUCD as compared to the interval group (p˂0.05)

Conclusion: Intra-caesarian placement of IUCD leads to statistically significant higher continuation rates as compared to conventional interval placement with no statistically significant difference in expulsion rates.