Contraceptive efficacy of intrauterine devices

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.

show abstract

“…These observations are similar to the previously reported cumulative pregnancy rate of less than 1/100 women within one year of use [9,10].…”

Section: Resultssupporting

confidence: 82%

“…The intrauterine device is an effective long lasting and reversible method of birth control [3,9,10]. The insertion of IUCDs is now gaining popularity as a method of postpartum contraception worldwide.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Postplacental Copper T 380A Insertion in Women Delivering by Caesarean Section

Singal

Bharti

Dewan

et al. 2014

JCDR

View full text Add to dashboard Cite

show abstract

“…In our study, there was a serious mismatch between the fertility desires of the participants and their current use of short-term contraceptive methods. No women were using the IUD, which is more than 98% effective in preventing pregnancy 5 and offers a quick return to fertility after removal. During data collection, none of the nurses at the five study sites was trained in IUD insertion and removal, and it is therefore not surprising that IUDs are not being used in family planning.…”

Section: Discussionmentioning

confidence: 99%

Is 'planning' missing from our family planning services?

et al. 2010

View full text Add to dashboard Cite

The benefits of family planning, in developing countries in particular, extend beyond decreasing fertility and include poverty reduction, improved health for both mother and child, the promotion of gender equality by increasing women's opportunities beyond reproductive and domestic activities, and environmental sustainability. 1 In addition, prevention of undesired pregnancies among HIV-positive women by eliminating unmet need for contraception is a highly cost-effective means of preventing mother-to-child transmission. 2In South Africa, free contraceptives are available at public sector health care facilities, and contraception use is high: an estimated 65% of sexually active women use a method.3 The method mix comprises predominantly short-acting methods -primarily injectable contraceptives. Long-acting contraceptives, such as the intra-uterine device (IUD), are highly effective among typical users owing to consistency of function, yet are underutilised in South Africa's public sector facilities. Of importance, especially in South Africa's high HIVprevalent setting, is that the IUD can be safely used on clinically well HIV-positive women. 4 The 2004 Demographic and Health Survey showed that 10% of sexually active women were sterilised, while less than 1% of women were using the IUD. 3 In preparation for an intervention aimed at improving contraceptive options, including long-acting and permanent methods (LAPM), for all postpartum women, we assessed women's knowledge and attitudes to LAPM. We report on findings from our baseline survey, which have prompted the question: Where is the 'planning' in family planning services? MethodsA cross-sectional study, approved by the University of Cape Town Health Science Faculty Human Research Ethics Committee, was conducted at five public sector primary care facilities in Cape Town between February and April 2009. Trained interviewers using a structured questionnaire collected data on: socio-demographics, contraceptive use, future fertility desires, and knowledge and attitudes towards LAPM, from 538 women of whom 265 were HIV-positive and 273 HIV-negative. The sample included HIV-positive and negative women to enable a comparison to be made of the uptake of an LAPM promotion intervention between prevention of motherto-child transmission (PMTCT) and non-PMTCT clients. All study participants were attending child health services, had received antenatal care during their most recent pregnancy, and had delivered less than 6 months before the interview. ResultsThe median age of the women was 26 years (interquartile range (IQR) 22 -31), 63.9% had achieved Grade 8 -12 without matric, 29.5% had post-matric qualifications, and the vast majority (94.2%) reported to be either married or single but in a stable relationship. Participants had a median number of 2 (IQR 1 -2) living children. Overall, 67.3% of the women did not want another child in the future, 39% reported that their partners did not want another child, and 62.4% reported that their most recent pregnancy was unplanned. Of ...

show abstract

“…24 The cumulative pregnancy rate at 5 years for the levonorgestrel-releasing intrauterine system is less than 0.5% and between 0.3% and 0.6% for the Copper T380A IUD. 27 As a result of high levels of user satisfaction, 28 and cost-effectiveness, 29 the IUD is the most widely used reversible method of contraception outside the United States. 30 Women with IUDs can undergo all forms of imaging, including computed tomograph (CT) and magnetic resonance imaging (MRI).…”

Section: Highly Effective Reversible Contraceptionmentioning

confidence: 99%

Contraception for Cancer Survivors

Schwarz

Hess

2009

J GEN INTERN MED

View full text Add to dashboard Cite

Women who have survived cancer may need guidance in choosing a method of contraception. This paper reviews the evidence supporting the safety and efficacy of available methods of contraception for cancer survivors and concludes that the Copper T380A intrauterine device (IUD), a highly effective, reversible, long-acting, hormone-free method should be considered a first-line contraceptive option for women with a history of a hormonally mediated cancer. However, the levonorgestrel-containing IUD may be preferable for women being treated with tamoxifen and women who have survived non-hormonally mediated cancers. Women with IUDs can undergo all forms of imaging, including computed tomography and magnetic resonance imaging.

show abstract

Contraceptive efficacy of intrauterine devices

Cited by 89 publications

References 44 publications

Clinical Outcome of Postplacental Copper T 380A Insertion in Women Delivering by Caesarean Section

Clinical Outcome of Postplacental Copper T 380A Insertion in Women Delivering by Caesarean Section

Is 'planning' missing from our family planning services?

Contraception for Cancer Survivors

Contact Info

Product

Resources

About