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Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD).
J Obstet Gynaecol India 2014; 64(5):337-43JO

Abstract

BACKGROUND

This study examines to describe the factors associated with acceptability of immediate PPIUCD insertion in women according to their socio-demographic and obstetrics characteristics, and future pregnancy desires and to determine the rates of uterine perforation, expulsion, pelvic infection, lost strings and displacement following PPIUCD insertion among the acceptors by 6 to 18 months.

AIM

An intrauterine device (IUD) is an effective form of Long Acting Reversible Contraception. Present study is aimed at determining the safety, efficacy, and expulsion of Post-placental and intra-cesarean insertion of Intrauterine contraceptive device (PPIUCD).

MATERIALS & METHODS

The study was conducted at District Head Quarters Hospital, Bolangir, Odisha, India. From 1st. January 2012 to 31st. December 2012. Women admitted and delivered at D.H.H. Bolangir, were counseled. CuT 380A was inserted within 10 minutes of delivery of placenta in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till 30th June 2013.

RESULTS

Total women counseled 3209, Accepted 564, Declined 2645, lost to follow up 130, Followed up 434, COMPLICATIONS: 190 (Expulsion 39, Bleeding 102, String problem 49), Removal 43, Continuation 352.

CONCLUSIONS

The PPIUCD (Inserting CuT 380 A by 10 minutes after placental delivery) was demonstrably safe, effective, has high retention rate. The expulsion rate was not very high and it can be reduced with practice. With the high level of acceptance despite low levels of awareness, the government needs to develop strategies to increase public awareness of the PPIUCD through different media sources. It is also important to arrange training on PPIUCD in order to increase knowledge and skills among healthcare providers. This will also further promote PPIUCD use and aid in reduction of the expulsion rates. Cash incentives to the accepter, motivator and of course provider would bring about a substantial progress in the PPIUCD use in developing countries like India.

Authors+Show Affiliations

OBGYN, District Headquarters Hospital, Balangir, Odisha India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25368457

Citation

Mishra, Sujnanendra. "Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD)." Journal of Obstetrics and Gynaecology of India, vol. 64, no. 5, 2014, pp. 337-43.
Mishra S. Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). J Obstet Gynaecol India. 2014;64(5):337-43.
Mishra, S. (2014). Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). Journal of Obstetrics and Gynaecology of India, 64(5), pp. 337-43. doi:10.1007/s13224-014-0550-3.
Mishra S. Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). J Obstet Gynaecol India. 2014;64(5):337-43. PubMed PMID: 25368457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Safety, Efficacy, and Expulsion of Post-Placental and Intra-Cesarean Insertion of Intrauterine Contraceptive Devices (PPIUCD). A1 - Mishra,Sujnanendra, Y1 - 2014/05/18/ PY - 2014/02/19/received PY - 2014/04/22/accepted PY - 2014/11/5/entrez PY - 2014/11/5/pubmed PY - 2014/11/5/medline KW - Intracesarean insertion KW - Intrauterine device KW - Intrauterine device insertion KW - Postpartum contraception SP - 337 EP - 43 JF - Journal of obstetrics and gynaecology of India JO - J Obstet Gynaecol India VL - 64 IS - 5 N2 - BACKGROUND: This study examines to describe the factors associated with acceptability of immediate PPIUCD insertion in women according to their socio-demographic and obstetrics characteristics, and future pregnancy desires and to determine the rates of uterine perforation, expulsion, pelvic infection, lost strings and displacement following PPIUCD insertion among the acceptors by 6 to 18 months. AIM: An intrauterine device (IUD) is an effective form of Long Acting Reversible Contraception. Present study is aimed at determining the safety, efficacy, and expulsion of Post-placental and intra-cesarean insertion of Intrauterine contraceptive device (PPIUCD). MATERIALS & METHODS: The study was conducted at District Head Quarters Hospital, Bolangir, Odisha, India. From 1st. January 2012 to 31st. December 2012. Women admitted and delivered at D.H.H. Bolangir, were counseled. CuT 380A was inserted within 10 minutes of delivery of placenta in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till 30th June 2013. RESULTS: Total women counseled 3209, Accepted 564, Declined 2645, lost to follow up 130, Followed up 434, COMPLICATIONS: 190 (Expulsion 39, Bleeding 102, String problem 49), Removal 43, Continuation 352. CONCLUSIONS: The PPIUCD (Inserting CuT 380 A by 10 minutes after placental delivery) was demonstrably safe, effective, has high retention rate. The expulsion rate was not very high and it can be reduced with practice. With the high level of acceptance despite low levels of awareness, the government needs to develop strategies to increase public awareness of the PPIUCD through different media sources. It is also important to arrange training on PPIUCD in order to increase knowledge and skills among healthcare providers. This will also further promote PPIUCD use and aid in reduction of the expulsion rates. Cash incentives to the accepter, motivator and of course provider would bring about a substantial progress in the PPIUCD use in developing countries like India. SN - 0971-9202 UR - https://www.unboundmedicine.com/medline/citation/25368457/Evaluation_of_Safety_Efficacy_and_Expulsion_of_Post_Placental_and_Intra_Cesarean_Insertion_of_Intrauterine_Contraceptive_Devices__PPIUCD__ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25368457/ DB - PRIME DP - Unbound Medicine ER -