Enhancing contraceptive usage by post-placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy, and expulsion

TLDR

In many developing countries, over 100 million women wish to avoid pregnancy yet remain unprotected by contraception. The study aimed to evaluate the safety, complication rates, and continuation willingness of Cu T 380 A inserted within ten minutes of placental expulsion in vaginal and C‑section deliveries. An open‑label, prospective, longitudinal design was employed, with ethics approval from FOGSI. Insertion was successful in >99 % of cases, with 94.8 % of devices remaining in situ, a 5.2 % expulsion rate, no perforations, and no major complications, supporting the safety of early post‑placental Cu T 380 A placement.

Abstract

Background: More than 100 million women in developing countries would prefer to avoid a pregnancy; but they may not be using any form of contraception. The study was conducted to assess the safety, incidence of perforation /pain/bleeding/foul discharge and expulsion rates at 6 week follow-up and willingness to continue when Cu T 380 A inserted within ten minutes of placental expulsion both in vaginal and C-section deliveries. Methods: This was an open label, prospective, and longitudinal study. The study was approved by the ethics committee of FOGSI. Results: The insertion of Intrauterine Contraceptive Devices (IUCD) at KIMS, Hubli was easy in 99.52% of subjects after normal delivery and 100% in all subjects after assisted vaginal deliveries. The position of the CuT was in situ in 94.78% of subjects, ultra sonogram was used in 24.76 % to confirm location where threads were not visible in the vagina and in 6.19% of subjects the tip of IUCD was in the cervix which was pushed back into the uterus using artery forceps. It was expelled in 5.23% of patients. There was no case of perforation in this series and no other major complications. Conclusions: Inserting CuT 380 A at 10 minutes after placental delivery is safe leading to the expanding of the usage of IUCD meeting the unmet needs. The expulsion rates would be minimal if it was inserted by a trained provider and placed at the fundus.