Poster Session

P108. Comparative study of postplacental cu-t insertion in vaginal and caesarean deliveries



CONTEXT: To address the unmet need during the post-partum period the Ministry of Health and Family Welfare, Government of India developed a national strategy to expand Post-Partum Intrauterine Device (PPIUD) services among public sector facilities. Since, not much work has been done in assessing the complications and side effects of PPIUCD in CAESAREAN AND VAGINAL DELIVERIES, we decided to undertake this study. AIMS AND OBJECTIVE: To compare complications and side effects related to postplacental placement of PPIUCD in vaginal and caesarean section MATERIALS AND METHODS: The present study is hospital based prospective study to be conducted in Department of Obstetrics & Gynaecology, S.M.S. Medical College & attached group of Hospitals, INDIA from March 2015 onwards _x0000_PATIENTS: Women in immediate post placental period (within 10 minutes of placental expulsion) in vaginal and caesarean delivery who gave the consent to participate in the study and excluding the ones with who have contraindications to IUCD insertion. INTERVENTION: All pregnant women who are attending our antenatal clinic or admitted in the labor ward will be counselled for different postpartum family planning methods. Those women who chose PPIUD will be informed regarding advantages, limitations, effectiveness and side effects related to IUD. Every woman will be screened for clinical situations as per WHO medical eligibility criteria in the antenatal period, as well as immediately prior to insertion after delivery. The PPIUD (CuT-380A) will be placed within 10 minutes following delivery of the placenta using Kelly’s placental forceps after taking informed consent. MAIN OUTCOME MEASURE: Subjects will be followed up at 6 weeks postpartum and then at 3 months. During the follow up visit they will be subjected to detailed history and Per Speculum examination .In cases in which threads are not visible USG pelvis will be done to confirm the presence of IUCD in the uterus. RESULT: We found that expulsion rate is significantly higher in vaginal group (10%) as compared to caesarean delivery (2%) group at 3 months of follow up. Excessive bleeding is mostly commonly found complication (18% in both groups at 6weeks of follow up) CONCLUSION: Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential.