Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforatio
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Abstract
Objective: To determine the complications (infection, perforation and expulsion rate) of immediate postplacental insertion of intrauterine contraceptive device (Multiload Copper375) in postnatal patients.
Methods: A case series study was conducted between October 28, 2014 to April 30, 2018 in obstetrics and gynaecology department, Civil Hospital Karachi,-+ Informed consent was taken. Intrauterine contraceptive device (Multiload) was inserted immediately within 10 min after delivery of placenta. These women were observed to determine outcome (infection, perforation and expulsion) at the time of discharge and 6 weeks postpartum. Absence of all these were taken as satisfactory outcome.
Results: A total of 435 women were included in this study. 165 (38%) were delivered through cesarean section and 270 (62%) were delivered through vaginally. There were 36 (8.3%) cases of infection. The cumulative rate of expulsion and perforation at the end of sixth week of post insertion was 39 (9%) and 0% respectively and 360 (82.8%) had satisfactory outcome. Post-placental placements during cesarean delivery are associated with lower expulsion rates than post-placental vaginal insertions without increasing rates of postoperative complications like perforation, slightly increase infection rate following vaginal delivery.
Conclusions: Immediate postpartum insertion of IUCD is an effective, safe and easily reversible method of contraception. Rates of the complications (Infection, expulsion and perforation) are remarkably low.
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Copyright (c) 2018 Khanzada B, et al.
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Population of the world. 2018; Ref.: https://goo.gl/DakscN
Pakistan demographic and health survey. Ref.: https://goo.gl/XLqk7U
Dirk W, Norman DG. Reversible, Long-Action Reproductive Control with Frameless IUD for Intracesarean Insertion. J Gynecol. 2017; 2: 000S1005. Ref.: https://goo.gl/YYBGHd
Moore Z, Pfitzer A, Gubin R, Charurat E, Elliott L, et al. Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contracept. 2015; 92: 31-39. Ref.: https://goo.gl/YDqexi
Wildemeersch D, Goldstuck ND, Hasskamp T. Current status of frameless anchored IUD for immediate intracesarean insertion. DEV pErioD mED. 2016; 20: 9-17. Ref.: https://goo.gl/XKAqom
Bühling KJ, Zite NB, Lotke P, Black K, INTRA Writing Group. Worldwide use of intrauterine contraception: a review. Contraception. 2014; 89:162–173. Ref.: https://goo.gl/ocHN9Z
Balasubramaniam S, Kumar S, Sethi R, Charurat E, Lalchandani K, et al. Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India. Int J Integr Care. 2018: 18: 7. Ref.: https://goo.gl/UMQPkE
Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009; 80: 327-326. Ref.: https://goo.gl/YX8hhb
Celen S, Moroy P, Sucak A, Akhtuly A, Danisman N. Clinical outcomes of early postplacental insertion intrauterine contraceptive devices. Contraception. 2004; 69: 279-282. Ref.: https://goo.gl/sTt7BE
Bhutta SZ, Butt IJ, Bano K. Insertion of Intrauterine Contraceptive Device at Caesarean Section. J Coll Physicians Surg Pak. 2011; 21: 527-530. Ref.: https://goo.gl/XEtQnM
Kittur S, Kabadi YM. Enhancing contraceptive usage by post placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy and expulsion. Int J Reprod Contracept Obstet Gynecol. 2012; 1: 26-32. Ref.: https://goo.gl/ukgQBA
Tomar B, Saini V, Gupta M. Post-partum intrauterine contraceptive device: acceptability and safety. Int J Reprod Contracept Obstet Gynecol. 2018; 7: 2011-2017. Ref.: https://goo.gl/U4TgVF
Çelen Ş, Sucak A, Yıldız Y, Danışman N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section. Contraception. 2011; 84: 240–243. Ref.: https://goo.gl/hdczEG
Lester F, Kakaire O, Byamugisha J, Averbach S, Fortin J, et al. Intracesarean insertion of the Copper T380A versus 6 weeks postcesarean: a randomized clinical trial. Contraception. 2015; 91: 198-203. Ref.: https://goo.gl/wqWcnN
Cleland, J, Shah, I and Benova, L. A fresh look at the level of unmet need for family planning in the postpartum period, its causes and program implications. Int Perspect Sex and Reprod Health. 2015; 41: 155–162. Ref.: https://goo.gl/jwHK6k
Ragab A, Hamed HO, Alsammani MA, Shalaby H, Nabeil H, et al. Expulsion of Nova-T380, Multiload 375, and Copper-T380A contraceptive devices inserted during cesarean delivery. Int J Gynaecol Obstet. 2015; 130: 174–178 Ref.: https://goo.gl/i1H1Ni
Levi EE, Stuart GS, Zerden ML, Garrett JM, Bryant AG. Intrauterine device placement during caesarean delivery and continued use 6 months postpartum: a randomized controlled trial. Obstet Gynecol. 2015; 126: 5–11. Ref.: https://goo.gl/63DA6i
Turok DK, Leeman L, Sanders JN, Thaxton L, Eggebroten JL, et al. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial. Am J Obstet Gynecol. 2017; 217: 665.e1-665.e8. Ref.: https://goo.gl/Qq5BYT