Outcome Of Immediate PPIUCD At Follow Up Visit In Women At A Tertiary Care Hospital In Karachi, Pakistan

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