Article Text

other Versions

PDF
Non-visualisation of strings after postplacental insertion of Copper-T 380A intrauterine device
  1. Rupali Dewan1,
  2. Abhinav Dewan2,
  3. Sunita Singal3,
  4. Rekha Bharti4,
  5. Mansi Kaim5
  1. 1Dr Rupali Dewan, Professor, Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  2. 2Dr Abhinav Dewan, Attending Consultant, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
  3. 3Dr Sunita Singal, Senior Clinical Advisor, Engender Health, India Country Office
  4. 4Dr Rekha Bharti, Assistant Professor, Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  5. 5Dr Mansi Kaim, Senior Resident, Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
  1. Correspondence to Dr Rupali Dewan, Professor, Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, Mahatma Gandhi Marg, Raj Nagar, Safdarjung, Ansari Nagar West, New Delhi 110029, India; rupalidewan{at}outlook.com

Abstract

Aim To assess the incidence of visible strings of intrauterine contraceptive devices (IUDs) after postplacental insertion following vaginal or caesarean delivery and to establish a management protocol of follow-up visits when strings are not visualised.

Methods This was a prospective study of a cohort of 348 women who underwent postplacental insertion of Copper-T 380A IUDs following vaginal or caesarean delivery, conducted at a hospital in New Delhi, India. Women were followed up at 6 weeks, 3, 6 and 12 months after IUD insertion and were questioned about IUD expulsion or removal at each visit. The cervix was inspected to visualise the IUD strings. All women whose IUD strings could not be visualised at the cervical os at any given follow-up were identified. We analysed the cumulative incidence of visible strings and of procedures performed to locate the IUD when strings were not visible.

Results At 1 year follow-up, the IUD was in situ in 313/348 (89.9%) women. There were eight (2.3%) expulsions and 15 (4.3%) IUD removals. Among women with IUDs in situ, the strings were not visible in 73 (21%) cases. Pelvic ultrasound confirmed intrauterine position of the IUDs in these cases. At 1 year, string visibility was significantly lower after intra-caesarean insertions as compared to vaginal insertions (72.4% vs 98.1%; p<0.05).

Conclusions Visualisation of strings after postplacental vaginal insertion is more common than after intra-caesarean insertion. Pelvic ultrasonography can be used to verify the presence of the device in cases of missing strings.

  • intrauterine devices
  • education and training

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Highlights from this issue
    British Medical Journal Publishing Group