ULTRASONOGRAPHIC ASSESSMENT OF PPIUCD PLACEMENT – DOES IT AFFECT THE CLINICAL OUTCOME?

Dr. Mohita Agarwal, Dr. Ruchika Garg, Dr. Rachana Agarwal, Prof. Saroj Singh, Dr. Pallavi Singh

Abstract


Abstract

Introduction: Intrauterine devices (IUD) are an effective safe, convenient and reversible method of contraception. Reaching postpartum women with family planning is a critical component to decreasing unmet need among women who want to limit or space their births.

Materials & Methods: One hundred fifty women attending the Department of Obstetrics and Gynaecology for delivery and willing for postpartum intrauterine contraceptive device (PPIUCD) insertion for contraception were enrolled for the study. They were divided into three groups depending upon the timing of insertion. After taking informed consent Copper T380A (CuT380A) which was supplied by Government of India free of cost was inserted. Cases were followed for three months at six weeks and three month interval. The position of the IUCD was correlated with the complications hereby reported by the woman.

Results: Mean IUD-fundus distance among those cases with an expelled IUD at the follow-up visit was 16.56 mm compared with 6.92 mm among women whose IUD was retained at the follow-up visit and the value was statistically significant in all the three groups. Though among the cases with complaints of pain and irregular bleeding, most of the cases had IUD-fundus distance  >10mm but the difference is insignificant.

Conclusion: Our study concluded that correct placement of postpartum intrauterine device is important to reduce the incidence of expulsion. Distance between uppermost part of endometrial cavity and uppermost part of PPIUD on ultrasound is a good predictor of expulsion rate and associated complications, higher the position of IUD in uterine cavity, less the chances of expulsion, abnormal uterine bleeding and pain.

Keywords: PPIUCD; IUD; Postpartum contraception; CuT380A; IUD-fundus distance; Ultrasound


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