Clinical and ultrasonographic evaluation of PPIUCD

Abstract

INTRODUCTIONIndia is the second most populated country in the world after China. According to the census 2011 the population of India on 1 st March 2011 was 1,210,193,422. In spite of the availability of wide range of contraception the unmet needs of contraception for family planning is estimated to be 12.8%, the reason for the unmet needs are mainly lack of information, fear about the side effects of contraceptive methods and unsatisfactory services.The recommended birth to birth interval in India is 36 months approximately 27% of birth in India occurs in less than 24 months after the previous birth and another 34% of birth occurs between 24 to 35 months. 1 The main reason for the decreased interval of birth is lack of knowledge of contraception in post-partum period. The contraception used during this period should be safe and effective and focus on extended post-partum period.Importance of post-partum family planning is as follows:• Maternal health: Women becoming pregnant at short intervals faces problems like anemia, abortion, premature rupture of membranes and high maternal mortality • Child health: short birth interval leads to increased risk of pre-term babies, Intra uterine growth retardation (IUGR), and increased death in neonatal period • To fulfill the Unmet needs: 65% of the women in first year of delivery have unmet needs for family planning. Only 26% of the of the women in India are using any contraception in first year after delivery. 2 ABSTRACTBackground: India is the second most populated country in the world. Effective contraception with low complication rates and high continuation rate in post-partum period can check population growth.Methods: This is a prospective study carried out at Mahatma Gandhi Hospital after ethical committee approval. 100 patients giving the informed consent were taken in the study. PPIUCD inserted in patients and they were followed up at 48 hrs, 6 weeks and 12 weeks by clinical examination and USG. Results: In this study, with PPIUCD insertion during LSCS, the expulsion and removal was observed in 4% and 14% whereas in cases with FTVD 8.33% expulsion and 12.5% removal were observed. 82% and 79.2% continued the use of PPIUCD in LSCS and FTVD respectively. The most common complain of the patients with PPIUCD were irritation because of thread. No case of pelvic infection or perforation was observed. There was no expulsion of PPIUCD when the distance of PPIUCD from fundus on USG was <10 mm. Conclusion: PPIUCD have high continuation rates with low complication rate. Distance of PPIUCD from fundus on USG is not a good indicator for predicting expulsion of PPIUCD.