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Indian Journal of Obstetrics and Gynecology Research


Clinical Outcome of Ppiucd (Copper-380A)-Intracaesarean Insertion


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Author Details: Lakshmi Garuda, Suhasini Kambham, Neelohita B

Volume : 2

Issue : 4

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 218

Article End Page : 226


Abstract

Background: This study examines the factors responsible for acceptability of the post placental intracaesarean insertion of IUCD among the clients in the study and evaluates the safety and efficacy and occurrence of complications like bleeding, missing strings, infection, pregnancy and expulsion and their incidence of occurrence after a follow up of 6 months post insertion.
Aim: To assess the acceptability, efficacy, feasibility and safety of IUCD insertion immediately after expulsion of the placenta in a caesarean section.
Materials and Methods: We have conducted a study on 220 patients delivering by caesarean section at our hospital, Kakatiya Medical College, Warangal, INDIA. After taking informed consent and explaining the patients about the advantages and limitations, we have succeeded in inserting intrauterine device cu-t380A immediately after expulsion of placenta in patients delivering by caesarean section in 220 patients and followed up the patients at 2-6 weeks and 6weeks-6months period to evaluate the safety, efficacy and complications occurring and their incidence of occurrence.
Results: Total women counseled were 480, Accepted in 231, Declined in 249. Intrauterine cesarean insertion was done in 220 patients and deferred in 11 patients due to post partum hemorrhage. Out of 220 patients, 28 patients lost to follow up, Removal rate was 20 and continued in 160. The total complications are 68 (Expulsion 12,Bleeding 20, Strings not visible 32,Infections 4,Pregnancy 0),These results were comparable to other national and international studies. We compared complications between elective and emergency intracesarean insertions and their statistical significance were evaluated.
Conclusion: Advantages of immediate post-partum insertion include high motivation, assurance that the woman is not pregnant, and convenience. However, expulsion rates appear to be higher than with interval insertion. The popularity of immediate post-partum IUCD insertion in countries as diverse as China, Mexico, and Egypt support the feasibility of this approach. Early follow-up may be important in identifying spontaneous IUD expulsions.