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.

Keywords

• Pregnant women, compliance, contraception, postpartum, menstrual cycle.