A cross-sectional study to evaluate the safety and efficacy of post-placental and intra-cesarean insertion of intrauterine contraceptive device
DOI:
https://doi.org/10.18203/2320-6012.ijrms20250254Keywords:
Post-partum contraception, Reproductive health, Caesarean section, IUCD, Cesarean section, Family planningAbstract
Background: India’s growing population necessitates effective postpartum contraceptive methods to reduce unintended pregnancies and to improve reproductive health outcomes. Postpartum intrauterine contraceptive devices (PPIUCDs) offer a reversible, long-term solution, but insertion timing- post-placental or intra-cesarean may affect their safety and efficacy. Objective was to compare the safety and efficacy of post-placental versus intra-cesarean insertion of IUCDs among postpartum women in a tertiary care hospital in Assam, India.
Methods: This prospective observational study enrolled 210 postpartum women from June 2023 to May 2024 at the Fakhruddin Ali Ahmed Medical College and Hospital, Assam. Eligible participants underwent either post-placental or intra-caesarean insertion of CuT 380A IUCDs. Data on demographics, complications, and continuation status were collected at six months post-insertion. Statistical analysis was done using appropriate statistical tests.
Results: Participants’ mean age was 28±4.1 years; 79.5% were primipara. Continuation rates of PPIUCD was 77.6%, with 26.4% and 19.3% discontinuing in the post-placental and intra-caesarean groups, respectively. Expulsion rates were higher in the post-placental group (15.4%) compared to intra-caesarean (1.7%) (p<0.001). Complications included excessive bleeding, pain, missing thread and expulsion. Factors such as age, parity, and insertion type influenced continuation, with multiparous women and intra-caesarean insertions demonstrating higher retention rates.
Conclusions: Intra-caesarean IUCD insertion is associated with lower expulsion rates and comparable continuation rates compared to post-placental insertion. Addressing social barriers and managing complications can further enhance PPIUCD utilization. These findings can help to design strategies for improving family planning interventions in similar settings.
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