A STUDY ON THE COMPARISON OF SAFETY AND EFFICACY OF POST PARTUM INTRAUTERINE CONTRACEPTIVE DEVICE (PPIUCD) WITH INTERVAL INTRAUTERINE CONTRACEPTIVE DEVICE

Abstract

Objective: To compare the safety and efficacy of post partum intrauterine contraceptive device with interval intrauterine contraceptive device, to avoid unplanned pregnancies.

Study Design: Quasi-experimental study.

Place and Duration of Study: Gynaecology and Obstetrics Department, Combined Military Hospital (CMH) Okara, from Aug 2019 to Jul 2020

Methodology: One hundred patients were included in the study. Divided in 2 groups, group A (post partum intrauterine contraceptive device, n=50) patients underwent cesarean section under spinal anesthesia, after removal of placenta and membranes contraceptive device was placed near fundus with fingers and incision was closed. In group B (interval intrauterine contraceptive device, n=50) and intrauterine contraceptive device was placed 6 weeks postpartum. Post insertion follow up was at 6 weeks and then 6 months. Efficacy was assessed by the continuation rate and safety, by presence or otherwise of heavy menstrual bleeding, lost threads, abnormal vaginal discharge and pain abdomen on follow up visits.

Results: Efficacy in group A was 46 (92%) and in group B 40 (80%). Safety that is heavy menstrual bleeding 3 (6%) and 5 (10%), lost threads 3 (6%) and 1 (2%), abnormal vaginal discharge 2 (4%), and 3 (6%), and pain abdomen 1 (2%) and 2 (4%) in groups A and B respectively.

Conclusion: Postpartum intrauterine contraceptive device insertion was found to be effective and safe method as compared to interval intrauterine contraceptive device. Successful placement, continuation and retention rate were significantly higher in post placental intra uterine contraceptive device insertion.