COMPARISON OF COMPLICATIONS OF POST PLACENTAL INSERTION OF INTRAUTERINE DEVICE IN VAGINAL DELIVERY VERSUS CESAREAN SECTION

Abstract

Background: The immediate postpartum intrauterine contraceptive device (PPIUCD) offers an effective, reversible contraception method during the delivery process. Recognized for its strategic role in family planning, PPIUCD facilitates timely contraceptive intervention in both vaginal and cesarean deliveries.

Objective: This study aims to evaluate the differences in complication rates associated with PPIUCD following vaginal versus cesarean deliveries at Lady Willingdon Hospital, Lahore.

Methods: This prospective cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Unit 1 of Lady Willingdon Hospital, Lahore. Participants were categorized into two groups: Group A for those undergoing vaginal delivery and Group B for cesarean section. PPIUCD insertion was performed immediately post-delivery, with follow-up evaluations at 6 weeks and 6 months postpartum to assess for complications such as lower abdominal pain, irregular vaginal bleeding, vaginal discharge, missed threads, and device expulsion.

Results: At the 6-week follow-up, no complications were reported in either group. By 6 months, there were no significant differences between the groups in terms of lower abdominal pain (Group-A: 0% vs. Group-B: 6%, p-value=0.079), irregular vaginal bleeding (Group-A: 2% vs. Group-B:6%), and spontaneous expulsion (Group-A: 6% vs. Group-B:0%). Vaginal discharge was reported by 20% of Group-A and 10% of Group-B (p-value=0.161). Missed threads were noted in 6% of Group-A and none in Group-B (p-value=0.079).

Conclusion: The study indicates no significant difference in the complication rates of PPIUCD between vaginal and cesarean deliveries in the short term. Long-term follow-up showed slightly higher but non-significant rates of vaginal discharge, missed threads, and spontaneous expulsion in the vaginal delivery group compared to the cesarean section group.