Profile of Acceptors and Outcome of Postpartum Intrauterine Contraceptive Device in a Tertiary Health Care Facility in West Bengal: A Prospective Observational Study
Authors/Creators
- 1. Registrar, Department of Obstetrics & Gynecology, Santevita Hospital, Ranchi, Jharkhand, India
- 2. Assistant Professor, Department of Obstetrics & Gynecology, Deben Mahata Government Medical College, Purulia, West Bengal, India
- 3. Associate Professor, Department of Obstetrics & Gynecology, Deben Mahata Government Medical College, Purulia, West Bengal, India
- 4. Professor & Head, Department of Obstetrics & Gynecology, Deben Mahata Government Medical College, Purulia, West Bengal, India
- 5. Senior Consultant, Department of Obstetrics & Gynecology, Deben Mahata Government Medical College, Purulia, West Bengal, India
Description
Background: In this study, we wanted to evaluate and analyse acceptance, effectiveness and complications of PPIUCD insertion in the postpartum period, assess the proportion of women accepting immediate PPIUCD insertion, find out the reasons for acceptance and decline of PPIUCD, find out the complications among the acceptors, follow post placental insertion and its outcome after 6 weeks, 3 months, and 6 months, evaluate the effectiveness of PPIUCD, and determine the reasons for removal of PPIUCD. Materials and Methods: This was a hospital based prospective observational study conducted among 106 patients who presented with normal or assisted vaginal delivery, caesarean section to the Department of Obstetrics and Gynaecology of Deben Mahata Government Medical College, Purulia, West Bengal, from July 2019 to December 2020 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Out of 106 patients 6(14.7%) patients had reversible reasons of acceptance of PPIUCD and 2(4.9%) patients had no interference with breast feeding reasons of acceptance of PPIUCD, 4(6.67%) patients did not want contraceptives immediately reason of decline of PPIUCD. 13(31.7%) patients had a mode of delivery CS, 26(63.41%) patients had a mode of delivery VD and 2(4.89%). 14(34.2%) patients had a history of previous use of contraception, 14(34.15%) showed no complications of PPIUCD and 27(65.85%) showed complications. 36 patients came for follow up at 6 months out of which 30 (83.33%) showed no complications. No case of pregnancy was found at follow up visits. Conclusion: PPIUCD is a safe, convenient, and highly effective postpartum intrauterine contraceptive device, which can be encouraged in both vaginal delivery and CS; it can be integrated with maternal child health services ensuring an appropriate long term reversible family planning method before returning home. To improve acceptance of PPIUCD, there should be a separate unit of antenatal counselling for the couples regarding the possibility of conception during lactational amenorrhea, morbidity related to consecutive conception, and the importance of birth spacing. Even in the postpartum period effectiveness of PPIUCD counselling can only be ensured if the couple is counselled together. Misconceptions and negative attitudes related to PPIUCD should be addressed through community-based activities and government strategies to increase public awareness through different media sources as another way of promoting the programme.
Abstract (English)
Background: In this study, we wanted to evaluate and analyse acceptance, effectiveness and complications of PPIUCD insertion in the postpartum period, assess the proportion of women accepting immediate PPIUCD insertion, find out the reasons for acceptance and decline of PPIUCD, find out the complications among the acceptors, follow post placental insertion and its outcome after 6 weeks, 3 months, and 6 months, evaluate the effectiveness of PPIUCD, and determine the reasons for removal of PPIUCD. Materials and Methods: This was a hospital based prospective observational study conducted among 106 patients who presented with normal or assisted vaginal delivery, caesarean section to the Department of Obstetrics and Gynaecology of Deben Mahata Government Medical College, Purulia, West Bengal, from July 2019 to December 2020 after obtaining clearance from the institutional ethics committee and written informed consent from the study participants. Results: Out of 106 patients 6(14.7%) patients had reversible reasons of acceptance of PPIUCD and 2(4.9%) patients had no interference with breast feeding reasons of acceptance of PPIUCD, 4(6.67%) patients did not want contraceptives immediately reason of decline of PPIUCD. 13(31.7%) patients had a mode of delivery CS, 26(63.41%) patients had a mode of delivery VD and 2(4.89%). 14(34.2%) patients had a history of previous use of contraception, 14(34.15%) showed no complications of PPIUCD and 27(65.85%) showed complications. 36 patients came for follow up at 6 months out of which 30 (83.33%) showed no complications. No case of pregnancy was found at follow up visits. Conclusion: PPIUCD is a safe, convenient, and highly effective postpartum intrauterine contraceptive device, which can be encouraged in both vaginal delivery and CS; it can be integrated with maternal child health services ensuring an appropriate long term reversible family planning method before returning home. To improve acceptance of PPIUCD, there should be a separate unit of antenatal counselling for the couples regarding the possibility of conception during lactational amenorrhea, morbidity related to consecutive conception, and the importance of birth spacing. Even in the postpartum period effectiveness of PPIUCD counselling can only be ensured if the couple is counselled together. Misconceptions and negative attitudes related to PPIUCD should be addressed through community-based activities and government strategies to increase public awareness through different media sources as another way of promoting the programme.
Files
IJPCR,Vol14,Issue9,Article41.pdf
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Additional details
Dates
- Accepted
-
2022-09-10
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/14/IJPCR,Vol14,Issue9,Article41.pdf
- Development Status
- Active
References
- 1. Population of India [internet]. 2019 [cited 2019 Sept. 14] Available from https://www.livepopulation.com/countr y/India.html 2. Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. International Family Planning Perspectives 2001;27(1):20-7. 3. Postpartum IUCD Reference Manual. Family Planning Division, Ministry of Health and Family Welfare, Government of India. Feb 2011. 4. World Health Organization. Reproductive Health and Research. Medical Eligibility criteria for contraceptive use. 4th edn. Geneva: Department of Reproductive Health and Research, World Health Organization 2010. 5. Conde-Agudelo A, Belizan JM. Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ 20 00;321(7271):1255-9. 6. Conde-Agudelo A, Rosas-Bermudez A, Kafury-Goeta AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA 2006; 295 (15) :1809-23. 7. Stamilio DM, DeFranco E, Emmanuelle P, Odibo AO, Peipert JF, Allsworth JE, et al. Short interpregnancy interval: risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstet Gynecol 2007;110(5):1075-82. 8. Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet 2006;368(9549):1810-27. 9. Rutstein S. Further Evidence of the Effects of Preceding Birth Intervals on Neonatal, Infant, and Under-FiveYears Mortality and Nutritional Status in Developing Countries: Evidence from the Demographic and Health Surveys. DHS Working Papers No. 41. Macro International; 2008. 10. Kumar S, Sethi R, Balasubramaniam S, Charurat E, Lalchandani K, Semba R, et al. Women's experience with postpartum intrauterine contraceptive device use in India. Reprod Health 20 14;11(1):32. 11. RICHA ROY, Postgraduate. A Prospective Study on Evaluation of Clinical Outcome of Ppiucd Insertion after Normal Vaginal Delivery and Cesarean Section. IOSR Journal of Dental and Medical Sciences (IOSRJDMS) 2019;18(11):47-51. 12. Kanhere AV, Pateriya P, Jain M. Acceptability and feasibility of immediate postpartum IUCD insertion in a tertiary care centre in Central India. Int J Reprod Contracept Obstet Gynecol 2015;4(1):179-84. 13. Jha P. Compendium of sessions addressing south Asian health at the 2012 APHA meeting. In: Jha P, ed. SAPHA Compendium. India: Compiled by the South Asian Public Health Association (SAPHA) 2012:8– 72. 14. Shukla M, Qureshi S; Chandrawati. Post-placental intrauterine device insertion-a five-year experience at a tertiary care centre in north India. Indian J Med Res 2012;136(3):432-5. 15. Rahaman M, Complications Following Immediate Postpartum Intrauterine Contraceptive Device Insertion among Pregnant Women. IOSR Journal of Dental and Medical Sciences (IOSRJDMS) 2019;18(1):4-9. 16. United Nations Population information network (POPIN), UN Population division, Department of Economic and Social Affairs with support from UN Population Fund. Network Intrauterine devices. Family Health International. Winter 1996;16(2).17. Maluchuru S, Aruna V. Postpartum – intrauterine device insertion – 2yr experience at a tertiary care center in Guntur Medical College /Govt. General Hospital, Guntur. IOSR Journal of Dental and Medical Sciences 2015;14(3):56-61. 18. Gaikwad S, Gurram A. Immediate postpartum insertion of an intrauterine contraceptive device during caesarean section. International Journal of Basic and Applied Medical Sciences 2014;4 (2):195-7. 19. Afshan A, Asim SS. Immediate postpartum IUCD (PPIUCD) insertion: an opportunity not to be missed. ASH &KMDC 2014;19(1):15-20. 20. Mangla M, Singla D. Post placental IUCD insertion – a systemic review at secondary health centre. IJIRS 2015; 4(3):81-7. 21. Jain N, Akhtar N. A Study to compare the efficacy, safety & outcome of immediate postpartum intrauterine contraceptive device (PPIUCD) with that of delayed insertion. IJSR 2015; 4(2):1338-91. 22. Isa B, Mairiga AG. Experience with intrauterine contraceptive device (IUCD) at university of Maiduguri Teaching Hospital. BOMJ 2012;9 (2): 34-7. 23. Srivastava D. M., Chowdhury D. S., & Vishal D. G. Giant Mucocele of Maxillary Sinus, Scarce Occurrence: Case Report. Journal of Medical Research and Health Sciences, 2022; 5(2): 1774–1778.