Abstract:
Objective: To evaluate the outcome of Immediate Post Partum Intrauterine Contraceptive device (PPIUCD) insertion
among married women of reproductive age at a tertiary care Creek General Hospital, Karachi, Pakistan.
Study Design: Prospective Interventional study.
Methodology: The clinical study was conducted in department of Obstetrics & Gynaecology, Creek General hospital
Karachi from August 2015 to July 2016. One hundred and twenty five women were selected for immediate PPIUCD
insertion, however the result was analysed for hundred women as twenty five were lost to follow-up. PPIUCD was inserted
within 10 minutes of delivery of placenta. Follow up was done at 6 weeks, the primary outcome measures were the clinical
outcomes in terms of safety (irregular vaginal bleeding, abnormal vaginal discharge, infection and perforation) and efficacy
(un-descended IUCD strings, expulsion, discontinuation and pregnancy). The results were analyzed by SPSS data analysis
software (IOBM).
Results: Among hundred women in whom PPIUCD was inserted and returned for follow-up, majority (44%) were in age
group 26-30 years; around 52% had primary or less education, and considerably high (84%) belonged to the low socio
economic status. Moreover, majority (46 %) had 3 or more alive children. Importantly, 73% women had IUCD inserted
after vaginal delivery. As safety was evaluated, irregular vaginal bleeding was observed in 15%, abnormal vaginal discharge
(20%), infection (11%), abdominal pain (4%) and perforation in only 1% of cases. Finally, in terms of efficacy the undescended
IUCD strings were observed in 7%, expulsion incidence (6%), discontinuation requested by (5%) and none of
the case ended up in pregnancy.
Conclusion: Post partum IUCD insertion immediately following delivery is an effective, safe, and acceptable long-term
reversible method available for postpartum contraception
