COMPARATIVE ANALYSIS OF IMMEDIATE POST PARTUM IUCD VERSUS INTERVAL POST PARTUM IUCD INSERTION

Abstract

Objective: This study aimed to compare the safety, efficacy, and acceptability of immediate postpartum intrauterine contraceptive device (PPIUCD) insertion with interval postpartum IUCD insertion.

Methods: A prospective comparative study was conducted over six months, involving 150 women equally divided into two groups. Group A (n=75) underwent immediate PPIUCD insertion within 10 minutes of placental expulsion or during cesarean section, while Group B (n=75) received interval IUCD insertion at 6-12 weeks postpartum. The same type of copper-bearing IUCD was used for all participants. Outcomes, including expulsion, infection, menstrual irregularities, continuation rates, and patient satisfaction, were assessed at 6 weeks, 3 months, and 6 months post-insertion.

Results: The demographic characteristics of both groups were comparable. The expulsion rate was higher in the immediate group (6.6% vs. 2.6%), but the difference was not statistically significant (p=0.28). Similarly, no significant differences were found in infection rates (4.0% vs. 2.6%, p=0.65) or menstrual irregularities (13.3% vs. 10.6%, p=0.61). No uterine perforations occurred in either group. Continuation rates at 6 months were high and similar between groups (88.0% for immediate vs. 90.6% for interval, p=0.59). Patient satisfaction was also high in both groups (89.3% vs. 93.3%, p=0.37).

Conclusion: Both immediate and interval postpartum IUCD insertions are safe, effective, and highly acceptable contraceptive methods with high continuation and satisfaction rates. The marginally higher expulsion rate in the immediate group was not statistically significant. Immediate PPIUCD insertion offers a valuable and convenient option for providing long-acting reversible contraception directly after delivery, supporting its integration into routine postpartum care.