Post-puerperal Cu-T insertion: a prospective study

Abstract

One hundred and sixty eight consecutive women accepting copper T (CuT) intrauterine contraceptive device in the post-puerperal period were studied. Out of them, 63 could be followed after 6 weeks of insertion and 65 after 6 months of insertion. The risk of heavy bleeding, pain in abdomen etc. were no greater than those usually found when interval CuT insertion is carried out. There was no case of uterine perforation leading to migration of CuT. But the expulsion rate was found to be high i.e. 16.4%. CuT is a very useful post-puerperal contraceptive method and should be given more importance in MCH programme.

PIP: Copper T IUDs were inserted in 168 postpartum women in Bombay, India, at 6 weeks to 3 months after delivery, and follow-up studies were made to compare results with those reported in the literature. 45.8% of the women were para 1, 46 were para 2, and 69% had accepted IUDs because they had at least one living male child. 63 of the women had follow-up examinations at 6 weeks, and 65 at 6 months. 11.1% and 16.9% complained of pain at 6 weeks and 6 months, respectively. The IUD was observed to be partially expelled and lying in the cervical os in 23.8% of the women at 6 weeks and in 9.2% at 6 months. Mild pelvic infection was diagnosed in 10% at 6 weeks and in 18% at 6 months, based on leukorrhea, erosion, or tenderness. There was 1 (1.5%) intrauterine pregnancy. These findings were comparable to previously reported results of large studies, with the exception of partial expulsion. Reasons cited in the literature for partial expulsion include parity, timing, and low insertion technique. The high incidence of partial expulsion was considered due to the atrophic or bulky uteri present in some of the women, and to the fact that only one size IUD was available.