Comparative analysis of postpartum IUDC versus interval IUCD insertion: a study conducted in a tertiary care hospital in Karachi, Pakistan

Zakia Bano; Sanober Memon; Fiza Ali Khan; Mala Jitendra Shahani; Urooj Naz; Syed Naqeeb Ali

doi:10.18203/2320-6012.ijrms20202269

Authors

Zakia Bano Department of Obstetrics and Gynecology, Darul Sehat Hospital, (LCMD) Karachi, Pakistan
Sanober Memon Department of Gynecology, NIBD Karachi, Pakistan
Fiza Ali Khan Department of Gynecology, Unit II, DUHS, Karachi, Pakistan
Mala Jitendra Shahani Department of Obstetrics and Gynecology, Jinnah Medical College Hospital, Karachi, Pakistan
Urooj Naz Department of Obstetrics and Gynecology, DUHS Civil Hospital, Karachi, Pakistan
Syed Naqeeb Ali Department of Pathology, Al-Tibri Medical College, Karachi Campus, Isra University, Hyderabad, Pakistan

DOI:

https://doi.org/10.18203/2320-6012.ijrms20202269

Keywords:

Effectiveness, Interval, Intrauterine contraceptive device, Postpartum

Abstract

Background: To compare the effectiveness of postpartum intrauterine contraceptive device (PPIUCD) with interval IUCD in terms of effectiveness, expulsions, bleeding pain and other complications at Tertiary care Hospital.

Methods: Current study was conducted among 224 women, at Gynaecology and Obstetrics of Reproductive Health Services-A (RHS-A) Centre of Jinnah Post Graduate Medical center, Karachi, for a period of Six months. Approval from Ethical committee and informed consent was taken from women and her husband before starting the study. The WHO medical eligibility criteria for contraceptive use (MEC) were followed and IUCD was inserted in 112 women in PPIUCD group and in 112 women in interval IUCD group. These cases were followed at 15 days, 6 weeks and 6 months. Results of PPIUCD group were compared with interval IUCDs group. Data was analyzed by using SPSS version 18.0. Continuous variables like age, parity, hemoglobin level were analyzed as mean±standard deviation. Frequencies and percentages were calculated for infection, expulsion, bleeding per vagina and effectiveness. Chi-square was applied to assess the difference between the categories. p value <0.05 was taken as significant.

Results: The two groups were identical in mean ± SD age, parity, residence and baseline hemoglobin level. PPIUCD (Group-A) was more effective i.e., 87.5% as compared to interval IUCD (Group-B) i.e., 83.9%. Pain, PID, bleeding and expulsion of IUCD were more prevalent with interval IUCD (Group-B) than PPIUCD (Group-A) patients. Stratified analysis showed that age, parity & mean baseline hemoglobin were non-significant effect modifiers on the effectiveness among the two groups.

Conclusions: Postpartum IUCD use was found to be a safe, simple, inexpensive and reversible procedure with higher chances of retention for a longer period. Additionally, there is decreased risk of complications and lower expulsion rates when compared with interval IUCD.

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