Gupta Purnima, Gupta Madhavi Mathur, Sharma Rachna
1Department of Obstetrics and Gynaecology, Gandhi Medical College and Associated Sultania Zanana Hospital, Bhopal, Madhya Pradesh India.
2Department of Obstetrics and Gynaecology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
J Obstet Gynaecol India. 2018 Apr;68(2):129-135. doi: 10.1007/s13224-017-1079-z. Epub 2017 Dec 2.
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.
为了有效且安全地控制生育，应了解印度女性放置宫内节育器（IUCD）以间隔生育或限制生育的理想时间。因此，我们旨在比较各种与IUCD相关的临床因素，以评估其在印度一家三级医疗中心进行即刻产后阴道放置、剖宫产术中放置、延迟产后放置和间隔期放置时的可接受性、安全性和有效性。
这是一项对2013年7月至2014年7月前瞻性收集的数据进行的回顾性分析。回顾了总共1631名符合条件母亲的产妇年龄、社会经济状况、教育程度、职业和产次等数据，并在产后组和间隔期组之间进行比较。还收集了这些女性中IUCD的自然排出率、无法摸到尾丝的患者比例、取出原因以及随访6个月内IUCD的失败率，并在即刻阴道放置、剖宫产术中放置、延迟产后放置和间隔期放置之间进行比较。
产后组和间隔期组的大多数女性年龄在20至35岁之间，有文化，经产妇，失业，且属于中/低社会经济阶层。即刻阴道放置、剖宫产术中放置、延迟产后放置和间隔期放置组的自然排出率分别为1.84%、0.84%、2.83%和1.63%；无法摸到尾丝的患者比例分别为3.07%、8.73%、4.45%和1.63%；取出率分别为7.99%、
