Comparison of complications of postpartum IUCD(PPIUCD) insertion with interval IUCD insertion in terms of complications like expulsion rate and bleeding
OBJECTIVE: The objective of the study was to compare complications of postpartum IUCD insertion with interval IUCD insertion in terms of complications like expulsion rate and bleeding.
STUDY DESIGN: This was prospective randomized controlled study.
SETTING The Study was conducted at Gynaecology and Obstetrics Department Unit 4, Bolan Medical Complex Hospital, Quetta
DURATION OF STUDY Six months i.e. 01-07-2019_31-12-2019
Methods: In this randomized controlled trial a total 102 women were included in the study. Study was started after taking approval from hospital ethical committee. All the women were briefed and motivated in antenatal period or latent phase of labour for PPIUCD insertion. The patients which were included in the study were randomly divided into two equal groups of 51 in each group. On group A IUCD (cuT 380 A) was inserted immediately after delivery within 48 hours and in group B the IUCD was inserted after 48 hours. After that bleeding and expulsion rate was noted at 3 visits including 15 days, 6 weeks and 6 months. All the data were analyzed using SPSS 16.
RESULTS: A total of 102 patients (51 in each group) were included in the study. The mean age of the patients was found to be 28.85 ± 4.83 years as overall. Gestational age of the patients was found as 38.0 ± 1.32 weeks in group A while 38.37 ± 1.21 weeks in group B. Also parity of the patients was assessed and was found as 3.84 ± 2.61 in group A while 3.92 ± 2.09 in group B. The main outcomes in this study were bleeding and expulsion of IUCD at 3 visits including 15 days, 6 weeks and 6 months. I had found that the difference in both groups was significant for IUCD expulsion rate at 15 days and 6 months visit. Bleeding and IUCD expulsion were stratified according to age, gestational age, parity and educational status and was non-significant at most of the times.
CONCLUSION: The IUCD expulsion rate at 15 days and 6 months was significantly less in patients having IUCD at postpartum than those having interval IUCD. Therefore on the basis of this study, we recommend that IUCD may be better inserted immediately after removal of placenta to prevent further complications.
KEYWORDS: IUCD; Post-partum; Bleeding; Expulsion; post partum intrauterine contraceptive device; Complications
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