RESUMO
Background@#Progressively increasing population of the country leads to unmet needs for responsible parenthood. This is reflective to reproductive age women with unplanned pregnancies which may consequently lead to maternal morbidity and mortality and adverse perinatal outcomes. Provision of family planning methods is implemented. One of the temporary methods of Long Acting Reversible Contraception (LARC) is Intrauterine Contraceptive Device (IUD). The effectiveness is similar to tubal sterilization with its perfect use. However, one of the drawbacks is dealing with its expulsion which affects its efficacy. @*Objective@#The study determined the expulsion rate between Immediate and Early postpartum IUD insertion after vaginal delivery. Expulsion rate was evaluated during the following periods: prior to discharge, after 4 weeks, after 12 weeks and 24 weeks post-insertion. @*Methodology@#This was an Observational Cross Sectional Study conducted for a year designed to collect data among patients who had IUD insertion after vaginal deliveries in a 6-month period of follow up. Sample size was computed using epi info 7.0. Finite Population Collection was derived to meet the population size available which resulted to 159 participants. Randomization was initiated to classify between immediate and early IUD insertion. Expulsion was observed during follow up at the family planning center of the institution @*Results@#This data showed no direct correlation in the expulsion rates between early and immediate postpartum IUD insertion. The expulsion rate was 6.25% for Immediate and 5.55% for Early IUD insertion respectively. There were no expulsion observed beyond 12 weeks post insertion. Relationship between early/immediate IUD insertion and expulsion rate was investigated using Chi square test. @*Conclusion@#Improved education and heightened awareness among reproductive aged women would initiate higher acceptance of IUD during postpartum period. Proper and improved technique of IUD insertion during postpartum period may decrease expulsion rate hence promoting better utilization of this family planning method.
Assuntos
Dispositivos IntrauterinosRESUMO
Resumen OBJETIVO: Determinar la permanencia del dispositivo intrauterino TCu 380A insertado después de algún procedimiento obstétrico efectuado a pacientes atendidas en el Hospital General Dr. Aurelio Valdivieso. MATERIAL Y MÉTODOS: Estudio transversal y descriptivo efectuado en pacientes que concluyeron el embarazo entre el 1 de octubre de 2016 y el 31 de marzo de 2017, en el Hospital General Dr. Aurelio Valdivieso y que aceptaron se les colocara el dispositivo intrauterino TCu 380A después de algún procedimiento obstétrico y antes de darlas de alta del hospital. Variables de estudio: cantidad de embarazos, terminación de estos, médico responsable de la colocación, técnica y permanencia. El análisis estadístico implementado fue el univariado. RESULTADOS: Se incluyeron 182 pacientes con media de edad de 23 años y límites de 14 y 43 años. En el seguimiento de la permanencia del dispositivo 42.3% (n = 77) se encontró in situ, 28.5% (n = 52) en mala posición, y 0.55% (n = 1) lo expulsó. CONCLUSIONES: La permanencia del dispositivo intrauterino parece tener una relación estrecha con la forma correcta de insertarlo y, desde luego, con la experiencia acumulada del médico. En las primeras inserciones el médico debe ser supervisado por otro de mayor experiencia o, simplemente, con la vigilancia de los médicos adscritos.
Abstract OBJECTIVE: To determine the permanence of the TCu 380A IUD inserted after the obstetric event in the Dr. Aurelio Valdivieso Hospital. MATERIAL AND METHODS: Cross-sectional and descriptive study carried out in patients who concluded their pregnancy, between October 1, 2016 and March 31, 2017, at the Dr. Aurelio Valdivieso General Hospital (Oaxaca, Mexico) and who accepted the placement of the TCu 380A intrauterine device during the postpartum period. and before discharge from the hospital. Study variables: number of pregnancies, termination of these, doctor responsible for the placement, technique and permanence. The statistical analysis implemented was univariate. RESULTS: The study was conducted in 182 patients with a mean age of 23 years, a minimum of 14 years and a maximum of 43 years. In the monitoring of the permanence of the IUD TCu 380A with 42.31% (77) was found in situ, 28.57% (52) in poor position, and 0.55% (1) was expelled. CONCLUSIONS: The permanence of the intrauterine device seems to have a close relationship with the correct way to insert it and, of course, with the accumulated experience of the doctor. In the first insertions the doctor must be supervised by another one of greater experience or, simply, with the surveillance of the assigned doctors.