A Study Of Acceptance, Follow Up & Outcome Of Post Partum Intra Uterine Devices

Dr. Mitesh V. Dhuda; Dr. Saral G. bhatiya; Dr. Pooja Agarwal; Dr. yogita Lad

Volume : IV, Issue : III, March - 2015

A Study Of Acceptance, Follow Up & Outcome Of Post Partum Intra Uterine Devices

Dr. Mitesh V. Dhuda, Dr. Saral G. Bhatiya, Dr. Pooja Agarwal, Dr. Yogita Lad

Abstract :

Objective : To study patient�s acceptance of PPIUCD. To study post insertion trends of follow up. To study any adverse factor / failure due to PPIUCD. Material and methods : This prospective study was carried out in the department of Obstetrics and Gynaecology at the Government Medical College and New Civil Hospital, Surat between January 2012 to January 2013.All pregnant and laboring women were counselled about the need for contraception as part of their counselling. The various options of contraception were discussed and the newly introduced postpartum insertion of IUCD was also discussed with them. The options of insertion of IUCD within ten minutes of placental delivery of during CS were explained. The safety and effectiveness of this method was emphasized. The common side effects and their management were also discussed to help these ladies make an informed choice.After insertion patients were counselled for follow up at seven days, six weeks and six months of delivery. They were discharged after 48 hours of normal delivery or on the fifth day of CS. Results : This study enrolled 961 subjects undergoing PPIUCD (CuT 380A) insertion in the immediate post placental period or during CS. Majority of our subjects was in the 21 to 25 years age group. Overall 65% of the acceptors were the ones who had undergone a CS. 72.42% did not have a single male child. Overall 71.38% subjects turned up for their 4–6 weeks follow–up (74.96% of subjects of CS and 64.67% of subjects of FTND turned up for their 4–6 weeks follow up). The difference in the follow–ups after CS and FTND at 4–6 weeks was statistically significant (p=0.001)t. At six months – almost 53% subjects were available for follow up with almost similar follow up rates after CS and FTND. Overall 28.61% subjects were lost at their 4–6 weeks follow–up (25.04% of subjects of CS and 35.33% of subjects of FTND were lost at their 4–6 weeks follow up). The difference in the lost to follow–ups after CS and FTND at 4–6 weeks was statistically significant (p=0.001). At six months – almost 46% subjects were lost to follow up with almost similar loss rates after CS and FTND. Subjects with FTND had a slightly higher complaints rate at six weeks (probably because tolerance of complaints was better by CS subjects) and those with CS had a slightly higher rate of complaints at six months follow up. The differences were not statistically significant. Though there was no statistical significance found between CS and FTND subjects regarding pain and bleeding problems at 4–6 weeks and 6 months follow up except for missing strings which was seen more in CS subjects at 4– 6 weeks follow up (p