CLINICAL OUTCOMES FOLLOWING POSTPARTUM INSERTION OF Cu375 VERSUS CuT380A IUCDs: A PROSPECTIVE STUDY

Abstract

Background: The effective and safe approach for long term contraception is the postpartum intrauterine contraceptive devices (PPIUCDs). However, concerns related to pain, abnormal bleeding, and expulsion may influence acceptance and continuation rates. This study is intended to evaluate the association between the type of PPIUCD (Cu375 vs. CuT380A) and common post-insertion complications, using ultrasonography to assess device position.
Methods: An observational prospective cohort study was conducted in New Delhi, from October 2019 to April 2021. In the study, a total of 150 postpartum women who underwent IUCD insertion (Cu375 or CuT380A) were included. Transabdominal and transvaginal ultrasonography were performed within 48 hours and at 6 weeks postpartum to assess device position. Patients’ symptoms including cramping pain, abnormal bleeding, and expulsion were recorded over a 3-month follow-up period.
Results: Cramping pain was reported by 27.3% of patients, with similar incidence in Cu375 (26.9%) and CuT380A (27.6%) groups (p = 1.000). Occurrence of abnormal bleeding was observed in 6.7% overall, slightly higher in CuT380A (9.2%) than Cu375 (1.9%) users (p = 0.166). The expulsion rate was 8.7%, with no significant difference between Cu375 (11.5%) and CuT380A (7.1%) (p = 0.362). Ultrasonographic evaluation was useful in confirming device position and guiding follow-up.
Conclusion: Both Cu375 and CuT380A PPIUCDs were associated with comparable rates of post-insertion symptoms and expulsion. Ultrasonography proved to be a valuable tool for early identification of malposition and management of complications. Selection of IUCD type can be individualized based on clinical context and patient preference.