Key result
Post-placental CuT insertion shows similar acceptability and complication rates compared to interval insertion.
Why the study?
Immediate postpartum period is an ideal time to commence contraception, but comparative data on post-placental versus interval IUCD insertion regarding acceptability, efficacy, and complications are needed.
Does post-placental IUCD insertion improve acceptability and reduce complications compared to interval insertion in postpartum women?
Observational (n=90)
No
Does post-placental IUCD insertion improve acceptability and reduce complications compared to interval insertion in postpartum women?
Absolute Event Rate: 85.7% vs 95.2%
p-value: p=0.25
Post-placental IUCD insertion is as safe, efficacious, and acceptable as interval insertion, with the added benefit of less perceived pain during insertion.
Immediate postpartum period is the ideal time to commence contraception as women are highly motivated and vulnerable to unwanted pregnancy at this time. The objective of this study was to compare the post-placental Intrauterine CuT device (IUCD) with interval IUCD in terms of acceptability, efficacy, and complications. A prospective observational study was conducted for a period of one year (January 2019 to January 2020) at a tertiary care center in India. Sixty and thirty women were included in the postplacental and interval group respectively. Data was analyzed at the end of 1 year, 4 women in post-placental and 9 in interval group were lost to follow up. Acceptability rate was high and comparable in both the groups (85.7% & 95.2%; p=0.25). Complication rate was similar in both groups (33.9% & 23.8%; p=0.39). The most frequent complication in the post-placental group was expulsion (14.2%), and heavy menstrual bleeding (9.5%) in the interval group. Multiparous women and who delivered vaginally had more risk of IUCD expulsion. Missing IUCD thread was seen exclusively in women who delivered by cesarean. Women who perceived ‘no pain’ during insertion were significantly higher in post-placental group than interval group (25% vs 0; p = <0.001). Overall satisfaction rate was similar and high (85.7% & 95.2%; p=0.58) in both the groups. Post-placental IUCD is more convenient, equally safe, efficacious, and acceptable than interval IUCD. All women should be counseled in the antepartum period for post-placental IUCD particularly in underdeveloped and developing countries.
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Khoiwal et al. (2021) conducted an observational in Postpartum contraception (n=90). Post-placental Intrauterine CuT device (IUCD) vs. Interval IUCD was evaluated on Acceptability rate (p=0.25). Post-placental intrauterine CuT device insertion demonstrated similar acceptability (85.7% vs 95.2%; p=0.25) and complication rates (33.9% vs 23.8%; p=0.39) compared to interval insertion.
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