Evaluation of awareness, acceptability, and clinical outcome of postpartum vaginal insertion and intra-cesarean insertion of intrauterine contraceptive device

Background: Post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD) is a lucrative family planning method which provides safe, effective reversible, inexpensive, non-hormonal, and long-acting contraception. Aims and Objectives: The objective of the study is to evaluate the postpartum insertion of intrauterine contraceptive device in terms of awareness, acceptance, safety, efficacy, continuation, and removal rate and its complications in both vaginal as well as intra-cesarean section (CS) insertion. Materials and Methods: Prospective observational study conducted in Obstetrics and Gynaecology Department GMERS sola for 6 months. Two thousand and ninety-four pregnant women from labor room who delivered vaginally or by CS during study period were asked regarding their knowledge and acceptability for PPIUCD. Results: Total 2094 women evaluated for awareness and acceptance for PPIUCD. About 68.66% were familiar with the concept with 29.99% giving verbal consent for its insertion. About 60.01% women refused for various reasons. Conclusion: This study shows that PPIUCD insertion is a safe and convenient method which requires more population awareness, counseling, and usage.

Evaluation of Acceptability, Safety, and Efficacy of Intrauterine Device Insertion during the Postpartum Period: A Prospective Analysis

Background: Intrauterine contraceptive devices (IUCD) are a rapidly reversible method of contraception. It is necessary toassess the acceptability and uptake of IUCD in parturients elaborating its safety and success.Aims and Objectives: The aim of the study was to evaluate the acceptability, safety, and follow-up of postpartum insertion ofIUCD both in vaginal and cesarean section deliveries among parturients with the ultimate goal is to avoid unplanned pregnanciesand to expand the usage of IUCD.Materials and Methods: The study was a prospective one conducted during the period of January 2014–January 2015. All theantenatal patients at their visits after 30 weeks of gestation were taken in the study and parturients accepted for postpartumIUCD (PPIUCD) insertion constitute the study population.Results: A total of 202 patients were included in the study population. Majority of cases accepted for PPIUCD had at leasta primary level of education, were primiparous, and had their last childbirth >2 years age consisting of 90.10%, 46.53%, and44.55%, respectively. About 27.72% of the parturients were aware of the PPIUCD and 58.91% of parturients accepted PPIUCDdue to its long-term effect. PPIUCD insertion done for the study was three types such as: Within 10 min, immediate (within 24 h),and trans-cesarean consisting of 23.76%, 15.35%, and 60.89%, respectively. About 96.04%, 79.70%, and 60.90% cases wereattaining for follow-up at 6 weeks, 3 months, and 6 months, respectively. At 6 week follow-up, pelvic inflammatory disease,irregular cycles, and pain were the chief concerns consisting of 34.16%, 23.27%, and 16.83%, respectively, whereas bleedingper vagina, lost string, and expulsion were less seen. PPIUCD expulsion was seen in 14.85% of the parturients.Conclusions: Awareness of the PPIUCD among women was poor despite high acceptance and needs strategies to increaseawareness. The PPIUCD was demonstrably safe, having no reported incidence of perforation with low rates of expulsion, pelvicinfection, and few lost strings.

Intrauterine contraceptive device embedded in bladder wall with calculus formation removed successfully with open surgery

@#An Intrauterine contraceptive devices (IUCD) is commonly inserted by the primary health care physician. It can migrate into pelvic or abdominal organs. When a pregnancy occurs following an insertion of an IUCD, there should be a high suspicion of uterine perforation or possible migration. A radiograph can be done in the primary health care clinic to search for a missing IUCD. Early referral to the urology service is warranted when a patient presents with recurrent urinary tract infections. Removal of an intravesical IUCD can be managed with cystoscopy, laparoscopy or open surgery. Herein, we report a case of IUCD migration into the bladder. This case will highlight the importance of proper technique, careful insertion and the role of ultrasound.

Role of IL-6 in the contraceptive mechanism of intrauterine device / 吉林大学学报(医学版)

Objective:To discuss the relationship between the serum level of interleukin-6 (IL-6) and the presence of an intrauterine contraceptive device (IUCD). Methods:The experimentalgroup was subdivided into the bleeding and the non-bleeding groups which consisted of 64 womenwith IUCD. There were 60 healthy women in the control group. The serum levels of IL-6 and C-reactive protein (CRP) were detected by enzyme-linked immunosorbent assay (ELISA) in bothgroups. Results :In the experimental group,the serum levels of IL-6 in 3 cases were increased,andthere was a significant difference in comparison with those of the control group (P＜0. 01),butthere were no statistical differences between the bleeding group and the non-bleeding group withIUCD (P＞0． 05). Serum CRP was negative both in the experimental groups and in the controlgroup. Conclusion:The non-bacterial endometrial inflammation induced by IUCD causes the in-crease of serum level of IL-6 in some women. It is suggested that IL-6 may play an important rolein the contraceptive mechanism of IUCD.