Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Quratulain Shabbir, Amna Usman, Attiya Yasmeen, Humaira Zafar, Falak Naz, Sanober Faisal


Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.

Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.

Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).

Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.  


Contraception, Post placental intra uterine device, Expulsion

Full Text:



Lanzola EL, Ketvertis K. Intrauterine Device. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2021. Available at: Accessed on 10 October 2021.

Munakampe MN, Zulu JM, Michelo C. Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review [published correction appears in BMC Health Serv Res. 2019;19(1):441.

Britton L. Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer. Clin J Oncol Nurs. 2017;21(2):189-96.

Lutalo T, Gray R, Santelli J. Unfulfilled need for contraception among women with unmet need but with the intention to use ccontraception in Rakai, Uganda: a longitudinal study. BMC Womens Health. 2018;18(1):60.

Curtis KM, Jatlaoui TC, Tepper NK, Zapata LB, Horton LG, Jamieson DJ et al. Selected Practice Recommendations for Contraceptive Use, 2016. MMWR Recomm Rep. 2016;65(4):1-66.

Chen BA, Reeves MF, Hayes JL, Hohmann HL, Perriera LK, Creinin MD. Post placental or delayed insertion of the levonorgetrel intrauterine device after vaginal delivery. Obstet Gynecol. 2010;116:1079-87.

Grimes DA, Lopez LM, Schulz KF, Van Vliet HA, Stnwood NL. Immediate post-partum insertion of intrauterine device. Cochrane Database Syst Rev. 2010;(5):CD003036.

Hubacher D, Spector H, Monteith C, Chen PL, Hart C. Long-acting reversible contraceptive acceptability and unintended pregnancy among women presenting for short-acting methods: a randomized patient preference trial. Am J Obstet Gynecol. 2017;216(2):101-9.

Cravioto MD. Nuevas recomendaciones de la Organización Mundial de la Salud (OMS) para el uso de los métodos anticonceptivos [New recommendations from the World Health Organization (WHO) for the use of contraceptive methods]. GacMed Mex. 2016;152(5):601-3.

Shukla M, Qureshi S, Chandrawati. Post-placental intrauterine device insertion - A five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136(3):432-5.

Sofat R. Postpartum CuT insertion - a trial. Indian J Maternal Child Health. 1990;1:23-4.

Celen, Moroy, Suvak, Aktulay, Danisman Clinical outcomes of early postplacental insertion of intrauterine contraceptive devices. Contraception. 2004;69:279-82.

Chi JC, Wilkens L, Rogers S. Expulsions in immediate postpartum insertions of Lippes Loop D and Copper T IUDs and their counterpart delta devices-an epidemiological analysis. Contraception. 1985;32:119- 34.

Thiery M, Kets VH, Van der Pas H. Immediate postplacental IUD insertion: the expulsion problem. Contraception. 1985;31:1-3.

Gupta P, Gupta MM, Sharma R. Intrauterine Copper Device (CuT380A) as a Contraceptive Method in the Indian Context: Acceptability, Safety and Efficacy Depending on the Timing of Insertion. J Obstet Gynaecol India. 2018;68(2):129-35.

Averbach SH, Ermias Y, Jeng G. Expulsion of intrauterine devices after postpartum placement by timing of placement, delivery type, and intrauterine device type: a systematic review and meta-analysis. Am J Obstet Gynecol. 2020;223(2):177-88.