ABSTRACT

Objective: To examine the safety and efficacy of immediate postpartum intrauterine contraceptive devices insertion after vaginal deliveries and cesarean sections.

Study Design: Prospective study

Place & Duration of Study: Department of Gynecology and Obstetrics Sughra Shafi Medical Complex Narowal from 1stJanuary 2015 to 31stDecember 2015.

Materials and Methods: One hundred and forty patients were included. The ages were ranging from 20 to 45 years and detailed history including age, residence and socioeconomic status was taken. They were divided into two groups; Group A (vaginal) and Group B (cesarean). Each group comprised equal number of females i.e. 70. Immediate postpartum intrauterine contraceptive devices were inserted in all the patients. Outcomes were examined at follow-up and compared between both groups.

Results: Sixty (42.86%) patient’s age range was between 20 to 30 years, 68 (48.57%) patients had ages 31 to 40 years and 12 (8.57%) patients had ages above 40 years. Complication rate was low. Perforation and pregnancy rate was 0%. Menstrual disturbance reported in 18 (14.75%) patients which was significantly higher in vaginal group. Expulsion rate was 5.73% and significantly higher in vaginal group p<0.05. Removal was done in 12 (9.84%) cases and rate of removal of intrauterine contraceptive device was high in vaginal group. Continuation rate at follow-up was 85.24%.

Conclusion: The insertion of immediate postpartum intrauterine contraceptive devices was effective and safe method with low complications rate.

Keywords: Efficacy, Intrauterine contraceptive device, C-section, Vaginal delivery