Outcome of Immediate Postpartum Intrauterine Contraceptive Device in Caesarean Versus Vaginal Insertion: A Comparative Study

Haleema Sadia; Gulfreen  Waheed; Nadia  Zahid; Sana  Navid; Sidra  Asif

doi:10.51253/pafmj.v76iSUPPL-1.13355

Authors

Haleema Sadia Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan
Gulfreen Waheed Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan
Nadia Zahid Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan
Sana Navid Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan
Sidra Asif Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13355

Keywords:

Cesarian Section, Postpartum Intrauterine Contraceptive Device, Vaginal Delivery

Abstract

Objective: To compare the outcome of immediate postpartum intrauterine contraceptive device in caesarean versus vaginal insertion.

Study Design: Quasi experimental study.

Place and Duration of Study: Department of Obstetrics and Gynecology, Avicenna hospital, Lahore Pakistan, from Oct 2024 to Mar 2025.

Methodology: After meeting selection criteria 250 females were enrolled and were divided in two groups of 125 each. Group-A were those females, who had vaginal delivery. Group-B was those females, who had cesarean section. Females were counseled about post-partum intra uterine contraceptive device (PPIUCD), and a CuT-80A was placed intrauterine. Outcome of PPIUD was noted in both groups.

Results: In this study the mean age of the participants was 29.64±6.51 years, among them, 56(22.4%) were nulliparous. After insertion of PPIUCD, Menstrual irregularities were observed in 40(32.0%) of those with vaginal delivery and 37(29.6%) of those with C-section delivery (p=0.681). Menorrhagia was reported in 40(32.0%) females with vaginal delivery compared to 11(8.8%) with C-section delivery (p<0.001). Fever occurred in 21(16.8%) vaginal delivery cases and 36(28.8%) C-section cases (p<0.001).

Conclusion: Based on this study, we may conclude that there were no statistically significant differences in the outcomes of immediate post-partum intra uterine contraceptive device (PPIUCD) insertion between caesarean and vaginal deliveries, except for the occurrence of menorrhagia and fever.

Downloads

Download data is not yet available.

References

1. Safty A, Ismail A, Zakaria AMM, Saeed AM. Efficacy of Immediate Insertion of an Intrauterine Contraceptive Device during Cesarean Section in Comparison with Late Insertion after the Puerperium. Al-Azhar Int Med J 2022; 3(12): 166-171.

https://doi.org/10.21608/aimj.2023.143720.1982

2. Singal S, Bharti R, Dewan R, Dabral A, Batra A, Sharma M, et al. Clinical outcome of postplacental copper T 380A insertion in women delivering by caesarean section. J Clin Diag Res 2014; 8(9): OC01-04.

https://doi.org/10.7860/JCDR/2014/10274.4786

3. Nelson AL, Chen S, Eden R. Intraoperative placement of the Copper T-380 intrauterine devices in women undergoing elective cesarean delivery: a pilot study. Contraception 2009; 80(1): 81-83.

https://doi.org/10.1016/j.contraception.2009.01.014

4. Mohamed SA, Kamel MA, Shaaban OM, Salem HT. Acceptability for the use of postpartum intrauterine contraceptive devices: Assiut experience. Med Princ Pract 2003; 12(3): 170-175. https://doi.org/10.1159/000070754

5. Sharma N. Comparing usefulness of immediate postpartum intrauterine contraceptive device among the women undergoing caesarean or vaginal insertion. New Indian J OBGYN 2022; 9(1): 89-93. https://doi.org/10.21276/obgyn.2022.9.1.17

6. Lanzola EL, Ketvertis K. Intrauterine Device. Treasure Island (FL): StatPearls Publishing; 2024. (Accessed on 24th March 2025) Available from:

https://onlinelibrary.wiley.com/doi/abs/10.1155/2016/7695847

7. Kavanaugh ML, Jerman J. Contraceptive method use in the United States: trends and characteristics between 2008, 2012 and 2014. Contraception 2018; 97(1): 14-21.

https://doi.org/10.1016/j.contraception.2017.10.003

8. Bahamondes L, Fernandes A, Monteiro I, Bahamondes MV. Long-acting reversible contraceptive (LARCs) methods. Best Pract Res Clin Obstet Gynaecol 2020; 66: 28-40.

https://doi.org/10.1016/j.bpobgyn.2019.12.002

9. Habib H, Lajber F, Khaliq S, Kareem R, Inayat S, Habib H. Outcomes of Immediate-Postpartum Intrauterine Contraceptive Devices in C-Section and Normal Deliveries. Pak J Med Health Sci 2020; 14(3): 1193-1195.

10. Shanavas A, Jacob S, Chellamma N. Outcome of immediate postpartum intrauterine contraceptive device in caesarean versus vaginal insertion: a comparative study. Int J Reprod Contracept Obstet Gynecol 2017; 6: 694.

http://dx.doi.org/10.18203/2320-1770.ijrcog20170407

11. Kanakuze CA, Kaye DK, Musabirema P, Nkubito P, Mbalinda SN. Factors associated with the uptake of immediate postpartum intrauterine contraceptive devices (PPIUCD) in Rwanda: a mixed methods study. BMC Pregnan Childbirth 2020; 20(1): 650.

https://doi.org/10.1186/s12884-020-03337-5

12. Ragab A, Hamed HO, Alsammani MA, Shalaby H, Nabeil H, Barakat R, et al. Expulsion of Nova-T380, Multiload 375, and Copper-T380A contraceptive devices inserted during cesarean delivery. Int J Gynecol Obstet 2015; 130(2): 174-178.

https://doi.org/10.1016/j.ijgo.2015.03.025

13. Meena AK, Meena S, Jatav U. A Hospital Based Comparative Study Of Post Partum Intrauterine Contraceptive Device Insertion In Vaginal Deliveries Versus Caesarean Section. Int J Acad Med Pharm 2025; 7(5): 15-19.

https://doi.org/10.47009/jamp.2025.7.5.4

14. Khan B, Jabeen SS, Yaqoob S. Outcomes of Immediate Postpartum Intra-Uterine Contraceptive Device (PPIUCD) Insertion in a Military Based Hospital. Pak J Med Health Sci 2018; 12(4): 1519-1521.

15. Halder A, Sowmya M, Gayen A, Bhattacharya P, Mukherjee S, Datta S. A prospective study to evaluate vaginal insertion and intra-cesarean insertion of post-partum intrauterine contraceptive device. J Obstet Gynecol India 2016; 66(1): 35-41.

https://doi.org/10.1007/s13224-014-0640-2

16. Parikh V, Gandhi A. Safety of copper T as contraceptive after caesarean section. J Indian Med Assoc 1989; 87(5): 113-115.

17. Sudha C, Priyanka H, Nagaiah D. A study to evaluate safety and efficacy of immediate postpartum postplacental IUCD insertion. Int J Reprod Contracept Obstet Gynecol 2017; 6(6): 2284-2289.

https://doi.org/10.18203/2320-1770.ijrcog20172071

18. Goldstuck ND, Cheung TS. The efficacy of intrauterine devices for emergency contraception and beyond: a systematic review update. Int J Women Health 2019; 11: 471-479.

https://doi.org/10.2147/IJWH.S213815

19. Levine EM, Fernandez CM. Paracervical Block for Intrauterine Device Placement Among Nulliparous Women: A Randomized Controlled Trial. Obstet Gynecol 2019; 133(1): 189.

https://doi.org/10.1097/AOG.0000000000003043