To Evaluate the Compliance of Postpartum Intrauterine Contraceptive Device at Jinnah Medical College Hospital

Abstract

Objective: To evaluate the compliance of Postpartum Intrauterine Contraceptive Device (PPIUCD)  in Jinnah Medical College Hospital, Korangi.

Methods: This cohort study was conducted in the obstetrics and gynaecology department of  Jinnah Medical & Dental College Hospital, Korangi for a period of one year from June 2016 to May 2017. All the pregnant women booked at  antenatal  clinic  of  Jinnah  Medical  &  Dental  College  Hospital  Karachi for delivery either vaginally or by caesarean section, after proper counselling or discussing the advan-  tages and disadvantages  of  method  were  included  in  study.  Patients  with  rupture  of  membranes  more than 18 hours, chorioamnionitis, congenital malformation  of  uterus,  large  uterine  fibroids  dis-  torting the uterine cavity, unbooked dai handled cases, coagulation disorders, fever, clinical symptoms of infection and patients who underwent postpartum haemorrhage were excluded from study.

Results: Total  number of women counselled in the outpatient department for PPIUCD were 2027 out         of which 1498 (73.9%) accepted the method. Insertions were carried out in (31.4%) women who de-   livered either vaginally and by caesarean section. Out of 31.4% insertions 93% followed up in out pa-     tient department (OPD) in which main  complaints  were  infections,  menstrual  cycle  problems,  dysparunia, abdominal cramps, expulsion and missed thread. PPIUCD  was  removed  in  21.49%,  rea- sons for removal noted were menstrual cycle irregularities, pressure from  family,  recurrent  infection,  myths and misconceptions. Expulsion took place in 3.9% and continuation rate was 74.5%.

Conclusion: On the basis of our overall results, PPIUCD was observed as a safe, timely, cheap and convenient method of contraception. Its advantage is that  women  are  in  our  immediate  reach  at  the time of delivery, so continuation of the method in this study is high (74.59%). Rate of insertion and compliance can be further improved by effective counselling of couples and by  arranging  public  awareness programs by multiple sources.