Abstract

Background: Insertion of post placental intrauterine contraceptive device (PPIUCD) has been recommended by the WHO, as one of the safe and effective methods of temporary contraception. In the immediate post delivery period, women are highly driven and in need of an effective method for contraception so that the child rearing can be easy without unintended pregnancy. rnObjective: To assess the outcome of women accepting PPIUCD in terms of insertion, complications and discontinuation rate at 6 weeks and 6 months. rnSubjects & MethodsrnStudy Design: Retrospective cross sectional study rnStudy Setting: Department of Obstetrics & Gynecology, Lahore General Hospital, Lahore, Study Duration: May, 2015 till August, 2019. rnData collection and analysis: After approval from hospital ethical committee, Data was retrieved from Maternal and Neonatal Child Health (MNCH) program. Record of clinical visit and telephonic survey for miscellaneous complaints at 6weeks and 6 months were evaluated from the medical records department and relevant data were extracted. The data were analysed using SPSS version 21 and the results expressed in descriptive statistics in frequency and percentages.rnResults: Total live births during study period were 43065. PPIUCD was inserted in 5275 women (12.24%). Only 13% presented for clinical follow up, 87% had telephonic conversation. Of these, 33% were advised clinical visit. 83% reported no complaints. Reassurance was needed in 11%, threads trimmed in 2%. Problems reported were displaced IUCD 3.3%, spontaneous expulsion 24%, vaginal infections 4.7%, missing strings 3%, cramping 25%, dyspareunia, 6%, spotting 52% vaginal discharge 16%. Ultrasound was advised to 3%, symptomatic treatment to 14%, antibiotics and IUCD removal in 0.7%. IUCD discontinued by 6.7% women for various reasons e. g family pressure 0.3%, wanting a further child 0.7% and 14% opted for another method of family planning. IUCD removed and reinserted in 4.9%.rnConclusion: PPIUCD has a low turnover rate of follow-up but has high compliance with devices and low complication rate and complications can be reduced by improving patient selection and clinical follow up. It provides an excellent window of opportunity for providing effective long term contraception to the patients who need it most.