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Efficacy of Post Placental Insertion of Intrauterine Contraceptive Device

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Introduction: The intrauterine device (IUD) is one of the most widely used contraceptive methods in the world. The main disadvantage of IUD contraception is the rate of expulsion and side effects. The mode of delivery, the physical properties of the IUD and the method and timing of insertion are all potential factors that may influence the outcome of IUD use and have been the subject of various studies.

Objective. To determine efficacy of post placental insertion of intrauterine contraceptive device.

Setting. Shaikhzaid Women Hospital Larkana Unit-1 from 15-01-2016 to 14-07-2016.

Design.Prospective study

Marerial and Methods:-A total of 220 cases that willing to birth control with intrauterine contraceptive device placed at the time of delivery were included in this study. Intrauterine contraceptive device was inserted after 10 minutes of expulsion of placenta after child and patients was followed till six months to record the expulsion of intrauterine contraceptive device. Efficacy of the IUCD was recorded on a pre designed proforma.

Results. The average age of the women in this study was 29.66±3.89 years. Efficacy of post placental insertion of intrauterine contraceptive device was observed in 90.45% cases.

Conclusion. post placental insertion of IUCDs is an effective, useful, safe, convenient and low-cost procedure for early postpartum contraception.

Key Words. Intrauterine contraceptive device, Post placental insertion and Contraceptive methods

INTRODUCTION.

The intrauterine device (IUD) is one of the most widely used contraceptive method in the world.1-2 More than 150 million women use IUDs, mainly in emerging countries, particularly in Southeast Asia and in the Middle East. 3 post-partum periods is one of the critical times when both women and newborn need a special and integrated package of health services as morbidity and mortality rates are quite high during this period and also the women are vulnerable to unintended pregnancy. Studies show that pregnancies taking place within 24 months of a previous birth have a higher risk of adverse outcomes like abortions, premature labor, post-partum hemorrhage, low birth weight babies, fetal loss and maternal death. In India, 65 percent of women in the first year post-partum have an unmet need for family planning. Hence contraception needs to be practiced in this critical period.

The main disadvantage of IUD contraception is the rate of expulsion and side effects, such as pain and bleeding, which may necessitate its early removal. The mode of delivery, the physical properties of the IUD and the method and timing of insertion are all potential factors that may influence the outcome of IUD use and have been the subject of various studies.5

Chen BA and others6 records 76% of the patients showing no expulsion of IUCD insertion soon after placental delivery while another study by shukla M and colleagues 7 and recorded its cumulative expulsion rate at the end of 6 month is 10.68 percent (89.32% no expulsion) showing a significant variation and creates to conduct another study to clarify the efficacy of device.

OBJECTIVE

To determine efficacy of post placental insertion of intrauterine contraceptive device

MATERIAL AND METHODS

This prospective study was conducted at Shaikhzaid Women Hospital Larkana Unit-1. Duration of study was six months from 15-01-2016 to 15-07-2016.The Reproductive age 20-45 years, Reproductive age 20-45 years and any parity were included in our study while Women with signs of uterine infection, Uterine abnormalities e.g. ruptured uterus (by medical records) were excluded from the study. A total of 220 cases fulfilling the inclusion criteria were enrolled from labor room unit-1 of sheikh zaid women Hospital Larkana after approval ethical review committee. Intrauterine contraceptive device was inserted after 10 minutes of expulsion of placenta after child and patients was followed till six months to record the expulsion of intrauterine contraceptive device. Efficacy of the IUCD was recorded (as per operational definition) by the researcher herself and recorded on a predesigned proforma (annexure).

Data was entered and analyzed in SPSS version 16.0. Mean. and standard deviation werecalculated for quantitative variables like age and parity. Frequencies and percentage were calculated for qualitative variables like efficacy. Stratification for age and parity was recorded to address the effect modifiers. Chi square test was applied. P value less than equal to 0.05 was considered as significant.

RESULTS

A total of 220 cases who willing to birth control with intrauterine contraceptive device placed at the time of delivery were included in this study. Age distribution of the cases is presented in figure 1. The average age of the women in this study was 29.66±3.89 years (95%CI: 29.14 to 30.18) as shown in table 1. Out of 220 cases, 127(57.73%) had 2 to 3 parity, 83(37.73%) had 4 to 5 parity and 10(4.55%) had more than 5 parity as shown in figure 2.

Efficacy of post placental insertion of intrauterine contraceptive device was observed in 90.45% cases as shown in figure 3. Similarly efficacy was significantly high in above 30 years of age cases as compare to below 30 years of age cases (p=0.036) as presented in table 2 while efficacy was not significant among different parity status of the women (table 3).

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Efficacy of Post Placental Insertion of Intrauterine Contraceptive Device. (2019, April 10). GradesFixer. Retrieved August 16, 2022, from https://gradesfixer.com/free-essay-examples/efficacy-of-post-placental-insertion-of-intrauterine-contraceptive-device/
“Efficacy of Post Placental Insertion of Intrauterine Contraceptive Device.” GradesFixer, 10 Apr. 2019, gradesfixer.com/free-essay-examples/efficacy-of-post-placental-insertion-of-intrauterine-contraceptive-device/
Efficacy of Post Placental Insertion of Intrauterine Contraceptive Device. [online]. Available at: <https://gradesfixer.com/free-essay-examples/efficacy-of-post-placental-insertion-of-intrauterine-contraceptive-device/> [Accessed 16 Aug. 2022].
Efficacy of Post Placental Insertion of Intrauterine Contraceptive Device [Internet]. GradesFixer. 2019 Apr 10 [cited 2022 Aug 16]. Available from: https://gradesfixer.com/free-essay-examples/efficacy-of-post-placental-insertion-of-intrauterine-contraceptive-device/
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