Comparative evaluation of IUCD insertion in postpartum period with interval period in a tertiary health care center of north India

Introduction: Postpartum IUD insertion provides long term and effective contraception but there are concerns regarding increase in the risk of expulsion or perforation among researchers and clinicians. This study compares PPIUCD versus interval IUCD. Materials and Methods: In study 125 postpartum (post placental and intra-caesarean) and 140 interval IUCD insertions (total 265 IUCD) were done. 245 cases completed the study 21 were lost to follow-up. Cu T 375 was used in the study. Exclusion criteria were -women with active PID, uterine anomaly, current carcinoma, chorioamnionitis or puerperal sepsis, prolonged rupture of membranes >18hrs, genital trauma, PPH history of ectopic pregnancy, any hemorrhagic disorder, genital infection, diabetes mellitus, heart disease, pelvic tuberculosis and woman or husband having multiple sexual partners. All were followed up for 6 months. Various socio-demographic factors and complications like expulsion, bleeding, pain, infection and medical removal were compared among groups. Results: Most women came for follow up in both the groups (PPIUCD-75.8% and Interval-71.2%). The expulsion rate in PPIUCD group (9.2%) was significantly higher than interval group (2.4%) (p<0 p=0.39).> Conclusion: There is an increased risk of expulsion in PPIUCD insertion but its benefits outweigh the risks. So this method should be popularised across the country as a very effective method of interval contraception.