Outcome of immediate postpartum insertion of intrauterine contraceptive device: Experience at tertiary care hospital.

OBJECTIVE: To determine the outcome of immediate post-placental intrauterine contraceptive device insertion in women. METHODS: This quasi-experimental study was conducted at Services Hospital Lahore, Pakistan, from August 2015 to January 2017.Postpartum intrauterine contraceptive device was inserted within 10 minutes of the delivery of the placenta in patients who gave informed consent. They were followed up at 6 weeks and 6 months and those who completed the follow-up were enrolled as study subjects. Data regarding safety, efficacy and continuation was collected at 6 months. Primary outcome measures were safety in terms of associated complications and secondary outcome measure was continuation rates. Efficacy was measured in terms of prevention of pregnancy. SPSS 23 was used for data analysis. RESULTS: A total of 8,000 eligible patients were counselled, out of whom 3,012(37.6%) exhibited a positive response and had postpartum intrauterine contraceptive device inserted. Of them, 1,250(41.5%) were followed up at 6 months and 833(66.6%) had no complications. Mean age was 30.2±11.4 years. Menstrual disturbances, vaginal discharge, lost string, misplaced device and expulsion were seen in 238(19%), 193(15.4%), 268(21.4%), 14(1.8%) and 75(6%) of the patients respectively. These complications except lost strings were comparable in vaginal and caesarean section insertions (p<0.05). Lost strings were more frequently observed in caesarean section group (p=0.001). Besides, 1,058(84.3%) patients wanted to continue this method of contraception. CONCLUSIONS: Postpartum intrauterine contraceptive device was found to be an effective, acceptable contraception with fewer complications for the patients.