Farhat Arshad, Lubna Ejaz, Humera Noreen, Naheed Bano, Shazia Syed, Rizwana Chaudhri

Dr Farhat Arshad
1Consultant Gynaecologist, Holy family Hospital, Rawalpindi
Email: farhat_68@hotmail.com

Abstract

Objective: To evaluate patient’s acceptance, satisfaction & complications regarding trans-caesarean Intra Uterine Contraceptive Device  or post placental intrauterine contraceptive device(PPIUCD)
Study Design: Descriptive case series.
Place and Duration: Gyn/Obs Unit – I Holy Family Hospital Rawalpindi from 01-06-2012 to 31-05-2013.
Methodology:  Pregnant  women who were P1 or more & required caesarean  (CS) section(elective or emergency) were counseled during antenatal visits & labour and consent taken. Trans-caesarean IUCDs were inserted in 240 cases. During follow up visit  at 6 wks, 3 and 6 months enquiry was made about  IUCD Expulsion, excessive bleeding, pain abdomen, backache, vaginal discharge and satisfaction rate, which  were recorded on predesigned  performa. Data fed to SPSS 16. Frequencies and percentages and Mean ± SD were computed to present all variables.
Results: Out of 240 trans- caesarean IUCD insertions and follow up at 6 wk, 3 and 6 months. Cases lost to follow up were 64 (26.66%), 74(30.83%), 80 (33.33%) at 1st, 2nd & 3rd visit, respectively. Out of 176 women at 1st follow up visit, 120/176(68.18%) came in person, 56 (31.81%) were followed on telephone.  Total follow up cases on 2nd & 3rd visit were 166 &160 women, among whom 108 (86.2%) Vs. 16 (13.7%) came in person and 99(88.3%) Vs 13(11.60%) were followed up on telephone. No problem was found in 94 ( 50.56%), but there were minor problems in 67( 38.06%). In 5 (2.8%) IUCD was expelled, while in 6 (3.4%) IUCD had to be removed on request at the end of follow up. A total of 156(88.6%) IUCDs in situ were confirmed clinically and 09(5.11%) by ultrasound. Expulsion rate was 2.8%. Satisfaction rate was 89.9% at the end of 6 months. No case of misplaced IUCD, PID or uterine perforation was reported.
Conclusion: Trans-caesarean IUCD is an effective method of contraception in developing countries like Pakistan.
Key Words: Post-placental IUCD (PPIUCD), Trans-caesarean IUCD, Effectiveness, Complications.   

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