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

ABSTRACT

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.