Sunita Singal1, Rekha Bharti2, Rupali Dewan3, Anjali Dabral4, Achla Batra5, Manjula Sharma3, Pratima Mittal6. 1. Ex Chief Medical Officer (SAG), Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital , New Delhi, India . 2. Assistant Professor, Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital New Delhi, India . 3. Consultant & Professor, Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital New Delhi, India . 4. Chief Medical Officer (SAG), Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital New Delhi, India . 5. Consultant & Associate Professor, Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital New Delhi, India . 6. Head of Department, Consultant & Professor, Department of Obstetrics and Gynecology, VMMC and Safdarjung Hospital New Delhi, India .
Abstract
INTRODUCTION: Short interconception period after caesarean section and its associated risk of increased morbidity, mortality and surgical interventions could be avoided by postplacental IUCD insertion during the procedure. Despite the safety reports on intracaesarean IUCD insertion, obstetricians are still hesitant to extend the benefit of this long acting reversible contraception to women undergoing operative delivery. OBJECTIVE: To study the clinical outcome (safety, efficacy, expulsion and continuation rates) of postplacental Copper T 380A insertion in primiparous women undergoing caesarean section. MATERIALS AND METHODS: This study was a prospective observational study, carried out in the Department of Obstetrics and Gynaecology, Safdarjung hospital, which is a tertiary care hospital of Northern India. Primiparous women who delivered by caesarean section over a period of six months (July 2012 to December 2012), willing for postplacental intracaesarean IUCD insertion, and willing to comply with the study protocol, were recruited for the study. All these subjects fulfilled the WHO Standard Medical Criteria for PPIUCD insertion; follow up visits were scheduled at 1, 3, 6 and 12 months. RESULTS: A total of 300 primiparous women underwent postpartum intracaesarean insertion of Copper T 380A. The mean age of women included in the study was 23.12 ± 2.42 years. Most common postinsertion complication observed in the immediate postoperative period was febrile morbidity (2%). Majority of women (94.33%) had hospital stay of less than 4 days. The common adverse events observed during follow-up of 12 months were menstrual complaints, excessive vaginal discharge and persistent pelvic pain. At the end of one year, there were 16 expulsions, 21 removals, and 2 pregnancies with gross cumulative expulsion, removal, failure and continuation rates of 5.33%, 7%, 0.67% and 91%, respectively. CONCLUSION: Postplacental intracaesarean Copper T 380A insertion in primiparous women is a safe and effective method of reversible contraception, with low expulsion and high continuation rates.
INTRODUCTION: Short interconception period after caesarean section and its associated risk of increased morbidity, mortality and surgical interventions could be avoided by postplacental IUCD insertion during the procedure. Despite the safety reports on intracaesarean IUCD insertion, obstetricians are still hesitant to extend the benefit of this long acting reversible contraception to women undergoing operative delivery. OBJECTIVE: To study the clinical outcome (safety, efficacy, expulsion and continuation rates) of postplacental CopperT 380A insertion in primiparous women undergoing caesarean section. MATERIALS AND METHODS: This study was a prospective observational study, carried out in the Department of Obstetrics and Gynaecology, Safdarjung hospital, which is a tertiary care hospital of Northern India. Primiparous women who delivered by caesarean section over a period of six months (July 2012 to December 2012), willing for postplacental intracaesarean IUCD insertion, and willing to comply with the study protocol, were recruited for the study. All these subjects fulfilled the WHO Standard Medical Criteria for PPIUCD insertion; follow up visits were scheduled at 1, 3, 6 and 12 months. RESULTS: A total of 300 primiparous women underwent postpartum intracaesarean insertion of CopperT 380A. The mean age of women included in the study was 23.12 ± 2.42 years. Most common postinsertion complication observed in the immediate postoperative period was febrile morbidity (2%). Majority of women (94.33%) had hospital stay of less than 4 days. The common adverse events observed during follow-up of 12 months were menstrual complaints, excessive vaginal discharge and persistent pelvic pain. At the end of one year, there were 16 expulsions, 21 removals, and 2 pregnancies with gross cumulative expulsion, removal, failure and continuation rates of 5.33%, 7%, 0.67% and 91%, respectively. CONCLUSION: Postplacental intracaesarean CopperT 380A insertion in primiparous women is a safe and effective method of reversible contraception, with low expulsion and high continuation rates.
Authors: Joshua D Dahlke; Eric R Terpstra; Abigail M Ramseyer; Jeanne M Busch; Thomas Rieg; Everett F Magann Journal: Contraception Date: 2011-02-24 Impact factor: 3.375
Authors: Sarah H Averbach; Yokabed Ermias; Gary Jeng; Kathryn M Curtis; Maura K Whiteman; Erin Berry-Bibee; Denise J Jamieson; Polly A Marchbanks; Naomi K Tepper; Tara C Jatlaoui Journal: Am J Obstet Gynecol Date: 2020-03-03 Impact factor: 8.661