Top PDF Evaluation of post partum intrauterine contraceptive device versus interval intrauterine contraceptive device insertion

Evaluation of post partum intrauterine contraceptive device versus interval intrauterine contraceptive device insertion

Evaluation of post partum intrauterine contraceptive device versus interval intrauterine contraceptive device insertion

According to Family Welfare Statistics 2011, Current population of India is 1.21 billion. 5.7% couples are effectively protected by using IUCD as a contraceptive measure. During the year 2010-11, 5.6 million IUCD insertion were reported as against 5.7 million in 2009-10. This shows decrease in acceptance rate of IUCD. Family planning is important not only for population stabilization, but it has been increasingly recognized as central tool to improve maternal and neonatal health.

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Prospective study on outcome of post partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

Prospective study on outcome of post partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

Results: The study shows that PPIUCD is an effective intervention in both caesarean and vaginal delivery with non- significant differences in safety and efficacy depending on the route of insertion. There was no case of perforation and no significant risk of infection in either caesareans or delivery. Spontaneous expulsion occurred in two cases inserted by vaginal route. Missing string incidence is high in the caesarean group compared to vaginal insertion.

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Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

of the present study is that infection was based upon self- report and was not corroborated by medical records or microbiological confirmation. 39 women (72.2%), had their PPIUCD removed within the first six weeks of insertion. Women most commonly reported expected side effects of IUCDs as the reasons for the removal, including bleeding and abdominal pain. These findings suggest that there is room for strengthening PPIUCD counselling services, particularly regarding normal side effects and complications that arise from method use. CONCLUSION
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A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

A comparative evaluation of post placental intrauterine contraceptive device (IUCD) insertion between normal delivery and caesarean section

Methods: This study was a prospective comparative study conducted in the department of Obstetrics and Gynecology, at Agartala Government Medical College over 1.5 Years (January 2016-June2017) All cases at term pregnancy delivering by caesarean section and vaginal delivery were divided into two different groups. Sample size of 105 in each group. Subjects recruited from-obstetrics OPD and casualty of Agartala Government Medical College (AGMC) and GB Pant Hospital expulsion rate and complications. Comparative evaluation of Expulsion rate and complications following post placental IUCD insertion between caesarean section and vaginal delivery at the end of six months, one year and one and half year.
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ACCEPTANCE OF POST PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE: RECENT INCREASE IN TREND

ACCEPTANCE OF POST PLACENTAL INTRAUTERINE CONTRACEPTIVE DEVICE: RECENT INCREASE IN TREND

period itself. Most of the patients are referred and their consent is recorded in the antenatal case record. The coverage rate was low in the first year compared to second and third year of the study period. Continuous motivation was provided and their works were supervised by checking the PPIUCD insertion compared to the number of deliveries on day to day basis instead of weekly review. This showed more than double fold increase in acceptance of PPIUCD approximately. Vidyarama et al. [1] in her experience at a tertiary care centre as a LARC showed an acceptance rate from 2 to 15% which varied according to age, parity, literacy. Our study showed higher acceptance in primi para which correlated with their study. They also share that there is need to strengthen our counseling services and motivate trained personnel to improve the acceptance rate which is very well correlated with our study. Mishrasujnanendra et al [2] in her study on evaluation of safety, efficacy, and expulsion of post-placenta and intracaesarean insertion of intrauterine contraceptive devices (PPIUCD) stated the importance to arrange training on PPIUCD in order to increase knowledge and skills among healthcare providers. This will also further promote PPIUCD use and aid in reduction of the expulsion rates. Cash incentives to the acceptor, motivator and of course provider would bring about a substantial progress in the PPIUCD use in developing countries like India and also stated that most of the PPIUCD acceptors were in the (20-29) age group, most of them literate, most of them Hindu followed by Christian and Muslim, acceptance with primi (64.5%) was higher than multi para women. Our study showed most of the PPIUCD acceptance were in the (20-24) age group followed by (25-29) age group
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Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

Postpartum women are especially vulnerable to unwanted pregnancy with increase rate of MTP or abortion after taking pill over the counter or septic abortion by untrained person especially in rural areas. Thus, there is increase in maternal morbidity and mortality. Women are highly motivated and receptive to accept family planning methods during post-partum period. Increase in Institutional deliveries all across the country created opportunities for providing quality family planning postpartum services.

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Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforation

Immediate postplacental insertion of intrauterine contraceptive device (copper 375) and its complications in term of expulsion, infection and perforation

Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended for long term temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. On the other hand, if they are made to wait for 6 week for initiating an effective contraception, they may conceive accidentally or may not come for contraception. Postpartum women is particularly important because they often have a higher unmet need for family planning, but may not perceive themselves to be at risk because their menses have not returned and/or they are breastfeeding [12]. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. Compared with sterilization, however, use of an intrauterine device (IUD) is simpler, less expensive, and immediately reversible. Insertion of an IUD after delivery may avoid the discomfort related to interval insertion, and any bleeding from insertion will be disguised by lochia. However, immediate post-partum IUD insertion may have disadvantages of spontaneous expulsion especially if post-delivery heavy vaginal bleeding.
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Profile of intrauterine contraceptive device (IUCD) acceptors at the Rivers State University Teaching Hospital, Southern Nigeria

Profile of intrauterine contraceptive device (IUCD) acceptors at the Rivers State University Teaching Hospital, Southern Nigeria

In this study, all the IUCD insertions were done within seven days of onset of menstruation after ruling out pregnancy. This time of insertion is associated with less discomfort and is generally easier to perform as the cervical canal is dilated. In addition, insertion related bleeding is masked during this time of insertion. IUCDs can also be inserted immediately post-partum but not more than 48 hours after delivery and post abortion [12, 27]. In our study, there were no post abortal or post-partum insertions. Levonorgestrel releasing intrauterine system (LNG-IUS) is yet to be made available in the family planning clinic of the hospital. IUCD has been cited by some workers as the best emergency contraception. Though the awareness of its use as an emergency contraception in our centre is very low, none of the clients used the IUCD for emergency contraception.
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Evaluation of postpartum intrauterine contraceptive devices (IUCD) insertion: 5 years study

Evaluation of postpartum intrauterine contraceptive devices (IUCD) insertion: 5 years study

available for postpartum contraception viz. lactational amenorrhea (LAM method), Pills, IUCD, Condom, sterilization but the women in the postpartum period wants an efficacious, reliable, safe, easy to use and a reversible contraceptive method which provide long term protection. All these criteria’s are fulfilled by PPIUCD. In the immediate post delivery period, the women are highly motivated and need an effective method of contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. On the other hand, if they are made to wait for 6 weeks for initiating an effective contraception, they may conceive accidently or may not come for contraception. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. Compared with sterilization, however, use of an IUCD is simpler, less expensive and immediately reversible. With this background authors have under taken the present study to assess the acceptance and complications of usage of postpartum IUCDs.
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Displaced intrauterine contraceptive device: a prospective study at tertiary level hospital of Uttarakhand, India

Displaced intrauterine contraceptive device: a prospective study at tertiary level hospital of Uttarakhand, India

A frequent clinical problem is loss of the filament at the external cervical os as the lost tail. This may be due to retracted or torn off tail, misplacement within the cavity, and growing uterus due to pregnancy causing retraction of threads, intramural penetration as extra uterine location. Proposed risk factors of uterine perforation include the immediate post-partum period and breast feeding, regardless of the timing of insertion. Both Andersson and van Haudenhoven have discussed the role of uterine involution and increased uterine contractility as potential contributing factors to IUCD perforation occurring in the postpartum period. 2,3 Procedure for
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Comparative study of post partum intrauterine contraceptive device in vaginal and intra caesarean insertion

Comparative study of post partum intrauterine contraceptive device in vaginal and intra caesarean insertion

After counseling, 11.5% of post placental group and 11.23% of intra cesarean group accepted the PPIUCD insertion. Acceptance and actual insertion rates are not high because PPIUCD is still a new concept in the community. Majority of women who gave consent for PPIUCD belonged to the age group of 21-25 years (60% in post placental and 53% in cesarean group) followed by 26-30 years 23% and 32% respectively This was probably because majority of the women who came to our tertiary hospital for delivery also belong to the same group. Halder et al also found that acceptance of PPIUCD was best in the age group of 21-25 years (40 and 44 % in vaginal and intra cesarean group)) followed by 25-30 years (31 and 23%) (Table 1). 6
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Evaluation of safety, efficacy and expulsion of post placental insertion of intrauterine contraceptive device

Evaluation of safety, efficacy and expulsion of post placental insertion of intrauterine contraceptive device

21. O’hanley K, Huber Dh April 2007, New York. Insertion at immediate postplacental and postpartum periods are demonstrably safe, because they have a low incidence of infection, few bleeding problems, and low perforation rates. In their study expulsion rates of about 7-15 per 100 users at six months in a well experienced and a skilled inserter. Most investigators have found that high fundal IUD placement will reduce the expulsion rate. Unplanned pregnancy rates range from 2.0-2.8 per 100 users at 24 months with modern copper IUDs. It appears that manual or ring forceps insertion result in very low perforation rates, e.g., 1/1150 immediate postpartum IUD insertions in 1 study.
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Post partum intrauterine contraceptive device: acceptability and safety

Post partum intrauterine contraceptive device: acceptability and safety

PPIUCD follow up card was given to all the parturients after insertion of PPIUCD. This included instructions about recognizing expulsion, postpartum warning signs i.e. unusual abdominal or pelvic pain, bleeding, unusual vaginal discharge or fever. PPIUCD card also contained information on the date of insertion, follow up visit, date of expiry of the IUCD and a telephone number for any query. These women were also advised to call on phone or come back any time in emergency department if they had any concern, experience any warning sign or if the IUCD is expelled.
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Factors affecting the behavior outcomes on post partum intrauterine contraceptive device uptake and continuation in Nepal: a qualitative study

Factors affecting the behavior outcomes on post partum intrauterine contraceptive device uptake and continuation in Nepal: a qualitative study

Moreover, this study also showed that lack of timely counseling on PPFP in the peripheral facilities led to missed opportunities. Health providers play a key role to address PPFP needs in a timely fashion [19, 20]. The previous quantitative study on PPIUD initiative indicated that multiple counseling by health providers had a significant influence on the uptake of PPIUD by women [10]. Another qualitative study focussing on the training of health providers on PPFP counsel- ing service and PPIUD insertion techniques had sug- gested that regular mentoring had helped in motivating the health providers on improving their services [11]. Despite the efforts, the gap on counsel- ing exists which is partly attributed to the low health providers to patients ratio in these busy hospitals [10]. The task shifting of PPFP services such as coun- seling by establishing community linkages could help address the gap to some extent. The female commu- nity health volunteers (FCHV) and the peripheral health facilities are often the first points of contact for most women in Nepal [21, 22]. Involvement of FCHVs by building their capacity has proven benefi- cial for many health interventions in Nepal [23, 24]. The capacity building process by integrating the train- ing packages on PPFP counseling for them into the national health system and by strengthening the local leadership to drive these training activities would be pertinent. Further, their inclusion in the BCC activ- ities is crucial to gaining women’s trust in the family planning method.
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Evaluation of effect of pospartum intrauterine contraceptive device

Evaluation of effect of pospartum intrauterine contraceptive device

Results: A total of 44 women fulfilling WHO standard medical criteria for PPIUCD insertion and willing to comply with study protocol had PPIUCD insertion. Cause of removal was mainly bleeding (2 cases, 50%) in interval IUCD group. 4 cases of spontaneous expulsion noted in vaginal delivery group prior to 6 weeks. The cumulative rate of complications were higher in PPIUCD group in our study (12 out of 44 i.e. 27.27% and 4 out of 20% in PPIUCD group and interval IUCD group respectively). Compliance of patient was highest in trans cesarean group 87.5%. Conclusions: Postpartum insertion of PPIUCD is safe effective, feasible and reversible method of contraception.
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Colposcopic and Cytological changes in intrauterine contraceptive device users: A Prospective study

Colposcopic and Cytological changes in intrauterine contraceptive device users: A Prospective study

76.5% of the IUD users in the present study had inflammatory changes in the cytology. Ismail H, el Tewil A, Fahmy k, in their study of cervical pathology with IUD – a cyto – colpo-pathological study. They studied 100 Lippes loop users and 100 Cu-T – 200 users for >1 year and 200 control non users by cytology, colposcopy and histo pathology for associated cervical pathology. They found significant increase in non specific inflammatory changes (P less than 0.05).in the IUD users than the non users. Ashwani etal reported an incidence of inflammatory changes of 57% at 6 wks, 72.6% at 6 months of Cu-T insertion.
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The Impact of Women-Centered Counseling on Intrauterine Contraceptive Device Satisfaction and Continuation

The Impact of Women-Centered Counseling on Intrauterine Contraceptive Device Satisfaction and Continuation

A sizable proportion of the studied women believed that IUD might travel inside a woman's body; she might conceive it, IUD acts as abortifacients, causes ectopic pregnancy and rots in the uterus after a prolonged use before the intervention. Similar finding was also reported as the most common misconceptions about IUD were pain during insertion and its ability to move inside the body [25]. After counseling, the above mentioned misconceptions were cleared up among women in the study group with a highly significant differences in favour of the study group (p=0.001*). This indicated the value of counselling in improving knowledge and self- efficacy in the study group. In this regard, study in India showed that the educational effort has succeeded in reducing various myths about the IUD such as; IUD travels to different body parts, or it causes dyspareunia and cancers [26]. Moreover, a qualitative study titled Wrong Ideas about Intrauterine Device among People of Isfahan found that, that fear of side effects, pain during insertion, problems with sexual intercourse, and fear of damage to the fetus were the main erroneous beliefs about IUDs. They recommended that providing special counseling to people who intend to use IUDs in the future can reduce the false perceptions in society and increase the use of IUDs by those who need to use this contraception method [27].
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<p>Knowledge and Practice of Contraception Use Among Females of Child-Bearing Age in Mosul, Iraq</p>

<p>Knowledge and Practice of Contraception Use Among Females of Child-Bearing Age in Mosul, Iraq</p>

The current study showed that the majority of the respondents had knowledge about contraception methods with a higher rate of knowledge toward intrauterine con- traceptive devices and oral pills followed by the injection method. These results are in accordance with previous studies in the region. 17,27,28 Knowledge about these two methods was obtained primarily from relatives and friends. Knowledge obtained from non-health professionals might be incorrect or incomplete. This may explain the high rate of women who were unfamiliar with how to deal with missing daily pills (79.4%). The result about the knowing what should be done if pills were missed was in contrast with a study conducted in Saudi Arabia, 29 in which 64.5% of their study participants knew how to deal with missed pills correctly.
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Use and discontinuation of intrauterine contraceptive device in the Greater Accra Region of Ghana

Use and discontinuation of intrauterine contraceptive device in the Greater Accra Region of Ghana

Women’s reasons for using the IUD varied slightly among current and ever users. Among current IUD users, preventing unwanted pregnancy emerged as the most important motivating factor, whilst the desire for a long acting FP was mentioned most often among ever IUD users. Although the ever IUD users would have loved to continue using the IUD, unbearable side effects of heavy menses and cramps lead to discontinuation. A further probe on this assertion shows that the type of IUD being referred to is the Cupper T 380 A . There were few reported instance were clients opted for LNG-IUS but was not available in the facility. Perhaps, the avail- ability of LNG-IUS (hormonal IUD) in facilities would have been preferred over Copper-T 380A which might have increased IUD usage in the study area. This sug- gests that among ever IUD users, there is an unmet need for LNG-IUS (hormonal IUD) which calls for program- ming and contraceptive security. The observation that IUDs have shown no or minimal reported side effects is an opportunity to use such satisfied clients for public education on IUDs to ensure continuity and increasing patronage since clients will really choose an IUD due to their understanding on the duration and perceived bene- fits over other methods.
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Intrauterine devices and risk of uterine perforation: current perspectives

Intrauterine devices and risk of uterine perforation: current perspectives

between 1972 and 2002, and the scope of laparoscopic surgery has certainly progressed in recent years. It could therefore be argued that a woman whose perforated IUD cannot be removed at initial laparoscopy should be referred to a surgeon with special skills in minimal access surgery, who may be more likely to remove a device successfully and safely than a general gynecologist. Occasionally “discretion is the better part of valor” and laparoscopy or laparotomy is abandoned when retrieval is unsuccessful in cases where the device has become densely adherent to, or buried in, vital structures. It should be noted that surgery to remove an IUD may itself cause adhesion formation. 109 Laparoscopic removal
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