Frequency of complications in immediate post-partum intrauterine contraceptive device insertion
DOI:
https://doi.org/10.63682/jns.v14i32S.9879Keywords:
Complications, Pelvic Inflammatory Disease, Postpartum, Intrauterine Device Insertion, Missed StringAbstract
Objective: To Determine The Frequency Of Complications (Pid, Expulsion Of Iud) And Missed String) Following Post-Partum Intrauterine Device Insertion
Study Design: Descriptive Study.
Setting: This Study Was Conducted At Department Of Obstetrics & Gynaecology, Shaikh Zaid Women Hospital, Larakana, Pakistan.
Duration: Six Months After The Approval Of Synopsis From December 9, 2019
To June 8, 2020.
Materials And Methods: All Patients Who Fulfilled The Inclusion Criteria And Visited To Shaikh Zyed Women Hospital, Larkana Were Included In The Study. Informed Consent Was Taken After Explaining The Procedure, Risks And Benefits Of The Study. Women Underwent Cesarean Delivery; The Iud Inserter Was Inserted Through The Hysterotomy Site After Delivery Of Baby And Placenta. In Those Patients Underwent Vaginal Delivery, It Was Placed In Uterine Fundus With The Help Of Long And Curved Forceps Without Lock (Kelly's Placental Forceps) For Vaginal Insertions. All Patients Were Assessed At 6 Weeks Duration For Complications (Pid, Expulsion Of Iud And Missed String). All The Collected Data Were Entered Into The Proforma Attached At The End And Used Electronically For Research Purpose.
Results: Mean ± Sd Of Age Was 28.5±6.6 Years. In Distribution For Mode Of Delivery, 85 (34.6%) Patients Had Vaginal Delivery While 161 (65.4%) Had Cesarean Section. Expulsion Of Iud Was Noted As Most Common Complication I.E. 55 (22.3%) Followed By Missed String 33 (13.4%) And Pelvic Inflammatory Disease (Pid) Was Documented In 16 (6.5%), While 142 (57.8%) Patients Had No Complications.
Conclusion: It Is To Be Concluded That Complication Rate Of Post-Partum Intrauterine Device Insertion Is Found To Be Fairly High. It Can Be Avoided If Proper Preventive Measures Are Taken And Increase Awareness Regarding Ppiud And Its Associated Complications ..
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1. Turok DK, Leeman L, Sanders JN, Thaxton L., liggebrolen JL Yonke N, et al. Immediate postpartum levonorgestrel intrauterine device insertion and breast-feeding outcomes: a noninferiority randomized controlled trial. Am Obstet Gynecol. 2017;217(6):665.e1-8.
2. Millar A, Vogel RI, Bedell S, Looby MA, Hubbs JL, Harlow BL, et al. Patterns of postpartum contraceptive use among Somali immigrant women living in Minnesota. Contracept Reprod Med. 2017;2(1):14.
3. Heller R, Johnstone A, Cameron ST. Routine provision of intiallerine contraception at elective cesarean section in a national public health service; a service evaluation. Aula Obstet Gynecol Scand. 2017,96(9):1144-51.
4. Hameed W, Azmat SK, Ishaque M, Hussain W, Munroe E, Mustafa G, et al. Continuation rates and reasons for discontinuation of intra-uterine device in three provinces of Pakistan: results of a 24-month prospective client follow-up. Health Res Policy Syst. 2015;13(1):S53.
5. Goldthwaite LM, Sheeder J, Hyer J, Tocce K, Teal SB. Post placental intrauterine device expulsion by 12 weeks: a prospective cohort study. Obstet Gynecol. 2017;217(6):674.e1- 8.
6. Cohen S, Livne PM, Ad-EI D, Lapidoth M. CO2 laser desiccation of urethral hair post- pcnoscrotallıypospadias repair. J Cosmet Laser Thach 2007;9(4):241-3.
7. Chen MJ, Hou MY, Hsia JK, Cansino CD, Melo J, Creinin MD. Long-Acting Reversible Contraception Initiation With a 2–3 Week Compared With a 6-Week Postpartum Visit. Obstet Gynecol. 2017;130(4):788.
8. Azmat SK, Hameed W, Hamza HB, Mustafa G, Ishaque M, Abbas G, et al. Engaging with community-based public and private mid-level providers for promoting the use of modern contraceptive methods in rural Pakistan: results from two innovative birth spacing interventions. Reprod Health. 2016;13(1):25.
9. Whitaker AK, Endres LK. Mistretta SQ, Gilliam ML. Postplacental insertion of the levonorgestrel intrauterine device after cesarean delivery vs. delayed insertion: a randomized controlled trial. Contraception. 2014;89(6):934-9.
10. Gupta A, Verma A, Chauhan J. Evaluation of PPIUCD versus interval IUCD (380A) insertion in a teaching hospital of Western UP. Int J Reprod Contracept Obstet Gynecol. 2016;2(2):204-8.
11. Muganyizi PS, Kimario G, Ponsian P, Howard K, Sethi M, Makins A. Clinical outcomes of postpartum intrauterine devices inserted by midwives in Tanzania. Int J Gynecol Obstet. 2018;143:38-42.
12. Kittur S, Kabadi YM. Enhancing contraceptive usage by post-placental intrauterine contraceptive devices (PPIUCD) insertion with evaluation of safety, efficacy, and expulsion. Int J Reprod Contracept Obstet Gynecol. 2012;1(1):26-32.
13. Shukla M, Sabuhi Qureshi C. Post-placental intrauterine device insertion-A five year experience at a tertiary care centre in north India. Indian J Med Res. 2012;136(3):432.
14. Speroff L, Darney PD. A clinical guide for contraception. Lippincott Williams & Wilkins; 2011;5:239-80.
15. Sood B, Asif R, Charurat E, Das S, Kumar S, McKaig C, et al. Revitalization of postpartum IUCD (PPIUCD) services: experience from India. Contraception. 2012 1;86(2):184-5.
16. Welkovic S, Costa LO, Faúndes A, de Alencar Ximenes R, Costa CF. Post-partum bleeding and infection after post-placental IUD insertion. Contraception. 2001;63(3):155-8.
17. Çelen Ş, Sucak A, Yıldız Y, Danışman N. Immediate postplacental insertion of an intrauterine contraceptive device during cesarean section. Contraception. 2011;84(3):240-3.
18. Gupta A, Verma A, Chauhan J. Evaluation of PPIUCD versus interval IUCD (380A) insertion in a teaching hospital of Western UP. Int J Reprod Contracept Obstet Gynecol. 2013;2(2):204-8.
19. Çelen Ş, Möröy P, Sucak A, Aktulay A, Danışman N. Clinical outcomes of early postplacental insertion of intrauterine contraceptive devices. Contraception. 2004;69(4):279-82.
20. United Nations Population Information Network (POPIN), UN Population division. Department of Economic and Social Affairs with support from UN Population Fund. Network Intrauterine devices, Family Health International. 1996;16(2).
21. Kapp N, Curtis KM. Intrauterine device insertion during the postpartum period: a systematic review. Contraception. 2009;80(4):327-36.
22. Müller AL, Ramos JG, Martins-Costa SH, Dias RS, Valério EG, Hammes LS, et al. Transvaginal ultrasonographic assessment of the expulsion rate of intrauterine devices inserted in the immediate postpartum period: a pilot study. Contraception. 2005;72(3):192-5.
23. Arck PC, Rücke M, Rose M, Szekeres-Bartho J, Douglas AJ, Pritsch M, et al. Early risk factors for miscarriage: a prospective cohort study in pregnant women. Reprod Biomed Online. 2008;17(1):101-13.
24. Tan PC, Mubarak S, Omar SZ. Gamma-glutamyltransferase level in pregnancy is an independent risk factor for gestational diabetes mellitus. J Obstet Gynaecol Res. 2008;34(4):512–7
25. Sridhar SB, Xu F, Darbinian J, Quesenberry CP, Ferrara A, Hedderson MM. Pregravid liver enzyme levels and risk of gestational diabetes mellitus during a subsequent pregnancy. Diabetes Care. 2014;37(7):1878-84.
26. Brasil. Ministério da Saúde. DATASUS. Informações de Saúde (TABNET). Estatística Vitais [Internet]. Brasília (DF): Ministério da Saúde; 2011.[citado 2014 Jul 31]. Disponível em: http://www.datasus.gov.br/DATASUS/index.php?area=0205.
27. Iqbal S, Sumaira S. Outcome of primigravida with unengaged versus engaged fetal head at term or onset of labour. Biomed. 2009;25(14):159-62.
28. Shaikh F, Shaikh S, Shaikh N. Outcome of primigravida with high head at term. J Pak Med Assoc. 2014;64(9):1012-4.
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