Comparision of efficacy and complications of insertion of IUD in
postplacental/postpartum period and postpuerperal/interval period: 1 year
follow-up*
K. Eroglu (1),G. Akkuzu (1), G. Vural (2), B. Özbey Dilbaz (4), A.
Ayse Akin (3), L. Takin (1), A. Haberal (4)
Department of Obstetrics and Women’s Health Nursing, School of Nursing,
Hacettepe University (1), Department of Obstetrics and Women’s Health Nursing,
School of Nursing, Gazi University (2), Department of Community Health, Faculty
of Medicine, Hacettepe University (3) and SSK Ankara Maternity and Woman’s
Health Hospital (4), Turkey
Aim: To compare the efficacy and complications of postplacental and
early postpartum intrauterine device (IUD) with postpuerperal and interval
insertion at the end of one year follow-up.
Material and Methods: The study was carried out at a teaching hospital
setting in collaboration with the Nursing School. Patients who chose to have
intrauterine device (Cu-T 380A) insertion and accepted to participate were
recruited in the study after being counselled and consented.The experimental
group (Group I) consisted of 84 patients who had postplacental ( 59 vaginal
delivery, 25 cesarean delivery ) and 46 patients who had early postpartum
insertion (N:130 women ), whilst the control group (Group II) covered 62
postpuerperal 76 interval cases ( N: 138 ). The demographic characteristics,
obstetric histories were recorded and the patients were followed-up for a year.
The data collected during the women follow-up at the end of the one month, the
housevisits at second and sixth month house-visits and telephone calls at 12 th
month by filling in the nurse follow-up forms. The groups were compared
statistically in terms of continuity of the method, complications as expulsion,
misplacement, complications and efficacy. The statistical analysis was carried
out using Chi-square, Fisher’s exact Chi-square, mean and percentage
calculations.
Results: At the end of one year follow-up 38.6% of Group I, 72.3% of
Group II had continuity of the method, the results showing a statistically
significant difference between the two groups. Among Group I, 84% of the
patients who left the method were from the early postpartum group mainly due to
IUD expulsion (78.2%). In Group II the main reason for leaving the method was
IUD misplacement (27.8%). The incidence of complete and partial expulsion was
significantly high in Group I but the two groups were not different
statistically from each other in terms of IUD misplacement, uterine perforation,
heavy bleeding and pelvic inflammatory disease. In Group I expulsion was
observed at an avarage of 57.64 days while partial expulsion was found at an
avarage of 69.56 days. The method efficacy was the same in both goups. In Group
I, become pregnant was %3.0 (4 women) and in Groups II was % 2.9 (4 women).
Conclusions: Postpartum IUD insertion is an acceptable, efficient
method of contraception. Counselling, integration of the family planning
activities with antenatal and maternity services and training the staff in
insertion techniques is required for improvement of the results.
* Sponsored by Hacettepe University Scientific Research Centre
