A Prospective Observational Study to Correlate Ultrasound Guided Detection of Position of Postpartum Intra-Uterine Contraceptive Device and Its Relation to Complications

Abstract

Introduction: Proper positioning of postpartum intrauterine contraceptive device (PPIUCD) is of utmost importance for efficacy and safety. The present study aimed to find the position of PPIUCD by ultrasonography and correlate the adverse effect and complication rate with location of IUCD.

Methods: This study was carried out in the Department of Obstetrics and Gynaecology of a tertiary-care-center of northern India from May 2021 to May 2022. The study group enrolled women who opted for PPIUCD after normal delivery or caesarean section and ready for follow up routinely after 6 weeks and 3 months. A clinical evaluation and Ultrasonographic (USG) examination was done on day 3 and on follow up visits (6 weeks & 3 months) for confirmation of IUCD position either at normal position or malposition. Women asked to report back in case of missing thread or missed period, abnormal bleeding, any discharge per vaginum, severe pain.

Result: 130 patients (65 in each group) were evaluated during study time. Majority of cases in both normal delivery (73.85%) and cesarean section (95.38%) were correctly placed. Most common malposition was midcavity (10%) cases and least common was oblique (1.53%). Continuation was higher in cesarean section (96.92%) at 6 weeks and (98.41%) at 3 months than normal delivery (95.38%) at 6 weeks and (98.41%)  at 3 months. Complaints was reported relatively more in normal delivery cases then in cesarean section.

Conclusion: USG helps in determining, whether PPIUCDs are placed in normal position or malposition. Correct placement of PPIUCD is important to reduce the incidence of expulsion.