Abstract

FREQUENCY OF EXPULSION IN IMMEDIATE POST-PARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTION

Dr. Nasreen Sultana*, Dr. Rehana Kamal, Dr. Afshan Mushtaq, Dr. Huma Naeem Tareen, Dr. Muhammad Saleem, Dr. Hayat Muhammad Kakar, Dr. Saleem Khan, Zaman Kasi

Abstract

Introduction: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the 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. Objective: To determine the frequency of expulsion of IUD following post-partum IUD insertion. Study Design: It was a cross-sectional study. Setting & Duration of Study: Study was conducted in Gynaecology and Obstetrics department, BMC/SPH Hospital, Quetta. from 17-08-2019 to 16-08-2020, Sampling Technique: Non- probability consecutive sampling. Methodology: They were counseled regarding IUD insertion and consent was obtained for it to be inserted. The inserter was then removed, and a ring forceps was inserted through the hysterotomy site to grasp the strings and insert them through the cervix from above, into the vagina. In those patients undergoing vaginal delivery, it was placed in uterine fundus with the help of long and curved forceps without lock for vaginal insertions. All patients were assessed at 6 weeks duration for expulsion as per operational definition. All data was analyzed using SPSS version 24.0. Results: A total of 305 patients were included in the study. The mean age of the patients was found to be 29.75 ± 5.50 years. Most of the patients had gestational age ≤ 37 weeks. The mean gestational age was 36.26±3.07 weeks. The mean parity of patients was found as 2.89 ± 1.42. The mean gravidity was 3.84 ± 1.40. Regarding mode of delivery, most of the patients (64.91%) were delivered through vaginal route. The main outcome of the study was expulsion of IUD, which was observed in 18 patients (5.90%). Conclusion: IUD is a strong weapon in the family planning armoury and should be encouraged in both vaginal and caesarean deliveries. Early follow-up should be encouraged to detect expulsions and tackle common problems.

Keywords: Contraception; Device; IUCD; Copper device; Postpartum.