Intrauterine Copper Device (CuT380A) as a Contraceptive Method in the Indian Context: Acceptability, Safety and Efficacy Depending on the Timing of Insertion
- 34 Downloads
Ideal time of Intrauterine copper device (IUCD) insertion either to space or limit births in Indian women should be known to check fertility effectively and safely. We therefore aimed to compare various IUCD related clinical factors to assess its acceptability, safety and efficacy in immediate postpartum vaginal insertion, intra-caesarean insertion, delayed postpartum insertion and interval insertion at a tertiary-care centre in India.
It was a retrospective analysis of prospectively collected data from July 2013 to July 2014. Data was reviewed about maternal age, socioeconomic status, education, occupation and parity of a total of 1631 eligible mothers and was compared between postpartum group and interval group. Data about spontaneous expulsion rate of IUCD, proportion of patients not able to feel thread, reasons for removal and failure rate of IUCD up to a follow-up period of 6 months was also collected in these women and compared among immediate vaginal insertion, intra-caesarean insertion, delayed postpartum insertion and interval insertion.
Majority of women were between 20 and 35 years of age group, literate, multiparous, unemployed and belonged to middle/lower socio-economic strata in both postpartum and interval groups. Spontaneous expulsion rates were 1.84, 0.84, 2.83 and 1.63%; proportions of patients not able to feel thread were 3.07, 8.73, 4.45 and 1.63%; and removal rates were 7.99, 6.48, 7.69 and 3.47% in immediate vaginal, intra-caesarean, delayed postpartum and interval insertion groups, respectively. Failure was seen in only one case of delayed postpartum insertion.
IUCD was more acceptable among young, literate and multiparous women as a contraceptive method. Immediate postpartum period was the safest and most efficacious time for IUCD insertion with least expulsion rate, maximum continuation rate and no failure and, therefore, should be encouraged by adequate counseling of mothers.
KeywordsIntrauterine copper device Postpartum Interval Contraception
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study formal consent is not required.
- 1.India at Glance—Population census 2011. Census organization of India, 2011. Available from: http://censusindia.gov.in/2011-prov-results/indiaatglance.html. Accessed on 9th June 2017.
- 2.International Institute for Population Sciences (IIPS), India. National Family Health Survey (NFHS- 4), 2015–16. Available from: http://rchiips.org/NFHS/pdf/NFHS4/India.pdf. Accessed on 9th June 2017.
- 3.Grimes DA, Lopez LM, Schulz KF, Van Vliet HA, Stanwood NL. Immediate post-partum insertion of intrauterine devices. Cochrane Database Syst Rev. 2010;5:CD003036.Google Scholar
- 8.Trussell J. Contraceptive efficacy. In: Hatcher RA, Trussell J, Nelson AL, Cates W, Stewart FH, Kowal D, editors. Contraceptive technology. 19th ed. New York: Ardent Media; 2007. p. 747–826.Google Scholar
- 10.Lucksom PG, Kanungo BK, Sebastian N, Mehrotra R, Pradhan D, Upadhya R. Comparative study of interval versus postpartum Cu-T insertion in a central referral hospital of North East India. Int J Reprod Contracept Obstet Gynecol. 2015;4(1):47–51.Google Scholar
- 11.Jain N, Akhtar N. A study to compare the efficacy, safety & outcome of immediate postpartum intrauterine contraceptive device (PPIUCD) with that of delayed insertion. Int J Sci Res. 2015;4(2):1388–91.Google Scholar
- 13.Bhutta SZ, Butt IJ, Bano K. Insertion of intrauterine contraceptive device at caesarean section. J Coll Phys Surg Pak. 2011;21(9):527–30.Google Scholar
- 15.Srivastava S, Bano I, Ishrat N. Evaluation of PPIUCD versus Interval IUCD Insertion. Int J Sci Res. 2016;5(7):1780–2.Google Scholar
- 17.Gupta A, Verma A, Chauhan J. Evaluation of PPIUCD versus Interval IUCD (380A) insertion in a teaching hospital of Western U. P. Int J Reprod Contracept. Obstet Gynecol. 2013;2(2):204–8.Google Scholar