The New Indian Journal of OBGYN. 10(2):361-365

Outcome of PPIUCD insertion following vaginal delivery and intracaesarean: a comparative study

Shaidul Islam Borah, Alakananda Das, Ankita Bagchi

ABSTRACT

Objectives: To evaluate the outcome of PPIUCD insertion and compare them among the two modes of insertion, that is, vaginal insertion with intra caesarean insertion. Materials and methods: Time bound prospective observational hospital based study undertaken from September 2021 to August 2022 at Gauhati Medical College & Hospital. Women who had delivered vaginally or by caesarean section along with PPIUCD insertion are included in the study. Results: Total 1000 patients including 500 cases of vaginal insertion and 500 cases of intracaesarean insertion were taken up for the study. Maximum number of cases was in the age group of 21-25 years. Awareness for follow up was found to be greater in intracaesarean group (99.4%) than vaginal insertion (97.6%). Acceptance was found to be higher among the primipara and literate group of people. At both 6 weeks and 6 months follow up, bleeding PV was the major complaint (8.48% and 4.88% respectively) and were more following vaginal PPIUCD insertion. Bleeding per vagina was also found to be more common reason for request of PPIUCD removal. Expulsion rate following vaginal PPIUCD insertion was 2.92% at 6 weeks and 3.88% at 6 months follow up while intracaesarean insertion had 1.02% and 1.9% expulsion rate at 6 weeks and 6 months respectively. Request for PPIUCD removal was more in vaginal insertion cases. Discontinuation due to PPIUCD removal and spontaneous expulsion was found to be 2.17% at 6 weeks follow up and 4.2% at 6 months follow up. However, overall 84.2% cases continued PPIUCD as the method of contraception thus implying better acceptance by the society. Conclusion: PPIUCD in the field of postpartum family planning is promising approach. Proper preinsertion and postinsertion counseling regarding pain and bleeding can make clients tolerant to the side effects and improve the continuation rate. Counseling regarding spontaneous expulsion of PPIUCD is needed which is more common following vaginal insertion, to prevent unwanted pregnancies.