Evaluation of Complications, Removal, and Continuation Rates Among Women Who Underwent Postpartum Intrauterine Contraceptive Device Insertion: A Retrospective Study

Background: Postpartum intrauterine contraceptive device (PPIUCD) is an established, safe, reversible, and long-acting contraceptive method. However, immediate post-delivery insertion of an IUCD may be associated with certain complications. Aim and Objectives: To evaluate complications, removal, and reasons for removal of PPIUCD among PPIUCD user women in our tertiary care centre. Materials and Methods: This is a retrospective study done by evaluating medical records of 260 PPIUCD user women. Incidence of complications such as abdominal pain, abnormal bleeding, abnormal vaginal discharge, and missing IUCD following PPIUCD insertion were assessed as primary outcomes. The secondary outcomes include removal rate and reasons for removal. Results: The mean (±SD) age of participants was 25.1 (±4.0) years with majority found in 21-30 years age group (76.9%). Majority of the IUCD user women i.e., 51.2% were multiparous followed by primiparous (48%). Major proportion of study participants delivered through vaginal route (80.4%) followed by cesarean section (19.6%). Out of total 260 PPIUCD users’ abdominal pain complication was observed in 15 women (5.8%), abnormal bleeding in 10 women (3.8%), and missed IUCD in only 4 women. Among 260 PPIUCD users, device removal was done in 18 patients (6.9%) majorly due to mutual decision by couple (6 users) and desire for pregnancy (5 users). One each user (0.4%) decided to remove PPIUCD because of change in family planning goals, completion of recommended IUCD duration, family size completed, personal preference, and wants to go tubectomy. Conclusion: PPIUCD is a scientifically validated, safe, reversible and long-acting contraceptive tool with high retention and success rates particularly beneficial in the tertiary care centre, where women live in remote areas and may not return for follow-up. Key words: PPIUCD, Abdominal pain, Bleeding, Family planning, Contraception, Follow-up