Evaluation of PPIUCD versus Interval IUCD Insertion

Background-Post Partum IUCD has the benefits of providing highly effective contraception immediately after delivery, particularly in the country like India where women have limited access to healthcare and have the unmet need of family planning. These women contribute to one- third of 100 million married women in the developing world. Aims and Objective- To study safety, efficacy, side effects, complications & continuation of PPIUCD and to compare with Interval IUCD insertion. Material and Methods- A Prospective observational study was carried out in the Department of Obstetrics and Gynaecology, J. N. M. C. H, A. M. U. , Aligarh. Participants were divided into two major groups. Postpartum IUCD insertion within 10 minutes of delivery of the placenta (Group I) and Interval IUCD insertion any time after 6 weeks of delivery (Group II). Follow-up of the participants was done at 6wks, 3mths and 6mths. Results- Menorrhagia, irregular bleeding and dysmennorhoea was significantly less in PPIUCD insertion (7.2 % v/s 21.9 %, p less than 0.001), ( 4.3 % v/s 17.5 %, pless than 0.001) and ( 1.4 % v/s 7.9 %, p less than 0.001) respectively. Pelvic infection and pain lower abdomen were also significantly less in PPIUCD insertion (1.1 % v/s 5.3 %, pless than 0.01) and (2.9 % v/s 12.2 %, pless than 0.001). Removal rate was significantly less in PPIUCD insertion (3.4 % v/s 8.8 %, pless than 0.05). There was no significant difference in expulsion, continuation rate and satisfaction, though expulsion rate was slightly higher in PPIUCD. Conclusion- PPIUCD is an effective, safe, reliable, long- term and convenient method of contraception. Compared to Interval IUCD, PPIUCD have less side effects.