Background: Intrauterine contraceptive devices (IUCDs) have been used by women in India for decades for spacing pregnancies. The increased institutional deliveries are an opportunity to provide women easy access to immediate PPIUCD services. Hence, we planned a study to evaluate the role of a novel dedicated inserter technique to improve compliance in postpartum women.
Materials and methods: A prospective case-control study was conducted on postpartum women who underwent vaginal delivery. Cases were selected and divided randomly into two groups: the long inserter (n = 292) and control groups (n = 301 using conventional method of insertion). PPIUD was inserted by trained providers, followed by ultrasound within 48 hours of insertion to assess location and fundal placement of the IUD. Follow-up was done at 2 weeks, 6 weeks and 3 months post-insertion, and ultrasound assessment was done for IUD location at each visit. Final statistical analysis was done by using Chi-square test.
Results: There were fewer complications like pain and irregular bleeding in the long inserter group as compared to the control group. None of the cases reported missing thread in the long inserter group. Expulsion was seen in only one case from the long inserter group and five cases in the control group. Client satisfaction was good (98.4%) in the long inserter group, and with each follow-up, satisfaction level also improved in the control group (96.6%, p value- 0.03).
Conclusion: The long inserter PPIUD insertion is a safe and convenient method. It has better ease of insertion, high fundal placement and good thread visibility and has reduced risk of infections as compared to the conventional PPIUD insertion technique.
Keywords: Conventional PPIUD; Kelly forceps; Long inserter Cu-T 375; Long-acting reversible contraceptive (LARC); Postpartum contraception.
© Federation of Obstetric & Gynecological Societies of India 2021.