Safety of Long Acting Reversible Contraception (LARC) during 3 Months of Follow up At Civil Hospital, Karachi
Safety of Long Acting Reversible Contraception
DOI:
https://doi.org/10.54393/pjhs.v5i06.1737Keywords:
Contraception, Counseling, Family Planning, Contraceptive Implant, Intrauterine DeviceAbstract
Contraception counseling is an essential component of family planning services. It provides the foundation for delivering correct information on contraceptive methods and eliminating myths regarding risks and negative effects. Objectives: To determine the Safety of Long-Acting Reversible Contraception (LARC) for postpartum contraception during 3 months of follow-up. Methods: A cross sectional descriptive study comprised on total of 108 women aged 25-35 years who accepted LARC in the postpartum period at Department of Obstetrics and Gynaecology, Civil Hospital, Karachi from 22nd February 2021 to 21st August 2021, were included. Females with uterine abnormalities and severe anemia were excluded. The demographic information (name, age, registration number) was taken. The women were counseled regarding postpartum contraception LARC such as IUD or Jedelle (implant) during the antenatal period and LARC was placed within 30 minutes of placental delivery. Those women who selected LARC were called for follow-up for 3 months in OPD and at follow-up visits, patients were assessed for their safety of this method. Results: The age range in this study was from 25 to 35 years with a mean age of 28.81 ± 3.27 years. The majority of the patients 80 (74.07%) were between 25 to 30 years of age. The mean parity was 3.10 ± 0.72. In this study, the safety of Long Acting Reversible Contraception (LARC) for postpartum contraception during 3 months of follow-up was found in 91 (84.26%) women. Conclusions: This study concluded that long acting reversible contraceptives in the immediate postpartum period are very safe.
References
Worldometer. Pakistan Population 2023. Worldometer. [Last Cited: 2nd Jun 2024]. Available at: https://www.worldometers.info/world-population/pakistan-population/#:~:text=Pakistan%202023%20 population%20is%20 estimated, (and%20 dependencies) %20 by%20 population.
Statista. Fertility rate in Pakistan 2021. Statista. [Last Cited: 28th Jun 2024]. Available at: https://www.statista.com/statistics/383207/fertility-rate-in-pakistan/.
Meherali S, Ali A, Khaliq A, Lassi ZS. Prevalence and determinants of contraception use in Pakistan: trend analysis from the Pakistan Demographic and Health Surveys Dataset from 1990 to 2018. F1000Research. 2021 Aug; 10: 790. doi: 10.12688/f1000research.55204.1. DOI: https://doi.org/10.12688/f1000research.55204.1
Nguyen M, Mason HR, Russell R, Fancher T, Chaudhry SI, Desai MM et al. Leave of Absence and Medical Student Placement into Graduate Medical Education by Race and Ethnicity. Journal of the American Medical Association. 2024 May; 331(18): 1588-1590. doi: 10.1001/jama.2024.4797. DOI: https://doi.org/10.1001/jama.2024.4797
Zapata LB, Tregear SJ, Curtis KM, Tiller M, Pazol K, Mautone-Smith N et al. Impact of contraceptive counseling in clinical settings: a systematic review. American Journal of Preventive Medicine. 2015 Aug; 49(2): S31-45. doi: 10.1016/j.amepre.2015.03.023. DOI: https://doi.org/10.1016/j.amepre.2015.03.023
Harper CC, Rocca CH, Thompson KM, Morfesis J, Goodman S, Darney PD et al. Reductions in pregnancy rates in the USA with long-acting reversible contraception: a cluster randomised trial. The Lancet. 2015 Aug; 386(9993): 562-8. doi: 10.1016/S0140-6736(14)62460-0. DOI: https://doi.org/10.1016/S0140-6736(14)62460-0
Pario S, Raja A, Abbasi S, Naz S. Awareness and Acceptance of Post-Partum Intrauterine Contraceptive Device Insertion (PPIUCD) among Patients Attending a Tertiary Care Hospital Karachi. Pakistan Journal of Medical & Health Sciences. 2023 Jun; 17(04): 345-. doi: 10.53350/pjmhs2023174345. DOI: https://doi.org/10.53350/pjmhs2023174345
Kumar S, Srivastava A, Sharma S, Yadav V, Mittal A, Kim YM et al. One-year continuation of postpartum intrauterine contraceptive device: findings from a retrospective cohort study in India. Contraception. 2019 Apr; 99(4): 212-6. doi: 10.1016/j.contraception.2018.12.003. DOI: https://doi.org/10.1016/j.contraception.2018.12.003
Eroğlu K, Akkuzu G, Vural G, Dilbaz B, Akın A, Taşkın L et al. Comparison of efficacy and complications of IUD insertion in immediate postplacental/early postpartum period with interval period: 1 year follow-up. Contraception. 2006 Nov; 74(5): 376-81. doi: 10.1016/j.contraception.2006.07.003. DOI: https://doi.org/10.1016/j.contraception.2006.07.003
Nalini N, Singh B, Jha S, Singh AV. Acceptance, safety and efficacy of postpartum intrauterine contraceptive device. Journal of Family Medicine and Primary Care. 2023 May; 12(5): 868-73. doi: 10.4103/jfmpc.jfmpc_1392_22. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1392_22
Eggebroten JL, Sanders JN, Turok DK. Immediate postpartum intrauterine device and implant program outcomes: a prospective analysis. American Journal of Obstetrics and Gynecology. 2017 Jul; 217(1): 51-e1. doi: 10.1016/j.ajog.2017.03.015. DOI: https://doi.org/10.1016/j.ajog.2017.03.015
Holland AC, Strachan AT, Pair L, Stallworth K, Hodges A. Highlights from the US selected practice recommendations for contraceptive use. Nursing for Women's Health. 2018 Apr; 22(2): 181-90. doi: 10.1016/j.nwh.2018.02.006. DOI: https://doi.org/10.1016/j.nwh.2018.02.006
Francis JK and Gold MA. Long-acting reversible contraception for adolescents: a review. Journal of the American Medical Association Pediatrics. 2017 Jul; 171(7): 694-701. doi: 10.1001/jamapediatrics.2017.0598. DOI: https://doi.org/10.1001/jamapediatrics.2017.0598
Durante JC, Sims J, Jarin J, Gold MA, Messiah SE, Francis JK. Long-acting reversible contraception for adolescents: a review of practices to support Better Communication, Counseling, and adherence. Adolescent Health, Medicine and Therapeutics. 2023 Dec: 97-114. doi: 10.2147/AHMT.S374268. DOI: https://doi.org/10.2147/AHMT.S374268
Fu TC, Herbenick D, Dodge BM, Beckmeyer JJ, Hensel DJ. Long-acting reversible contraceptive users' knowledge, conversations with healthcare providers, and condom use: Findings from a US nationally representative probability survey. International Journal of Sexual Health. 2021 Apr; 33(2): 163-74. doi: 10.1080/19317611.2020.1870024. DOI: https://doi.org/10.1080/19317611.2020.1870024
Armstrong MA, Raine-Bennett T, Reed SD, Gatz J, Getahun D, Schoendorf J et al. Association of the timing of postpartum intrauterine device insertion and breastfeeding with risks of intrauterine device expulsion. Journal of the American Medical Association Network Open. 2022 Feb; 5(2): e2148474-. doi: 10.1001/jamanetworkopen.2021.48474. DOI: https://doi.org/10.1001/jamanetworkopen.2021.48474
Kassa BG, Ayele AD, Belay HG, Tefera AG, Tiruneh GA, Ayenew NT et al. Postpartum intrauterine contraceptive device use and its associated factors in Ethiopia: systematic review and meta-analysis. Reproductive Health. 2021 Dec; 18: 1-2. doi: 10.1186/s12978-021-01273-x. DOI: https://doi.org/10.1186/s12978-021-01273-x
Divya RD. Clinical outcome of post placental copper T380A and copper 375 IUCD insertion in women delivering by caesarean section. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018 Sep; 7(9): 3731-8. doi: 10.18203/2320-1770.ijrcog20183785. DOI: https://doi.org/10.18203/2320-1770.ijrcog20183785
Sultana R, Badar N, Usmani SS, Hafeez M. Women's Experience with Postpartum Intrauterine Contraceptive Device. Journal of the Society of Obstetricians and Gynaecologists of Pakistan. 2022 Sep; 12(3): 267-71.
Lerma K, Bhamrah R, Singh S, Blumenthal PD, Mittal P, Das V et al. Importance of the delivery‐to‐insertion interval in immediate postpartum intrauterine device insertion: a secondary analysis. International Journal of Gynecology & Obstetrics. 2020 May; 149(2): 154-9. doi: 10.1002/ijgo.13115. DOI: https://doi.org/10.1002/ijgo.13115
Deo S, Sinha R, Chaurasia L, Deo PP. Awareness and Pattern of Utilizing Family Planning Methods in Married Women visiting at Janaki Medical College Teaching Hospital. Janaki Medical College Journal of Medical Science. 2023 Dec; 11(3): 55-62. doi: 10.3126/jmcjms.v11i3.60735. DOI: https://doi.org/10.3126/jmcjms.v11i3.60735
Tibaijuka L, Odongo R, Welikhe E, Mukisa W, Kugonza L, Busingye I et al. Factors influencing use of long-acting versus short-acting contraceptive methods among reproductive-age women in a resource-limited setting. BioMed Central Women's Health. 2017 Dec; 17: 1-3. doi: 10.1186/s12905-017-0382-2. DOI: https://doi.org/10.1186/s12905-017-0382-2
Hameed W, Azmat SK, Ali M, Ishaque M, Abbas G, Munroe E et al. Comparing effectiveness of active and passive client follow-up approaches in sustaining the continued use of long acting reversible contraceptives (LARC) in Rural Punjab: a multicentre, non-inferiority trial. PLOS One. 2016 Sep; 11(9): e0160683. doi: 10.1371/journal.pone.0160683. DOI: https://doi.org/10.1371/journal.pone.0160683
Whitaker AK and Chen BA. Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices. Contraception. 2018 Jan; 97(1): 2-13. doi: 10.1016/j.contraception.2017.09.014. DOI: https://doi.org/10.1016/j.contraception.2017.09.014
Levi EE, Findley MK, Avila K, Bryant AG. Placement of levonorgestrel intrauterine device at the time of cesarean delivery and the effect on breastfeeding duration. Breastfeeding Medicine. 2018 Dec; 13(10): 674-9. doi: 10.1089/bfm.2018.0060. DOI: https://doi.org/10.1089/bfm.2018.0060
Suri V. Post placental insertion of intrauterine contraceptive device. Indian Journal of Medical Research. 2012 Sep; 136(3): 370-1.
Abdel-Ghany A, Khalifa E, El-Din MZ, Ibrahim E, Abdallah A, Abdel-Aziz M et al. Intrapartum versus postpartum insertion of intrauterine device in women delivering by cesarean section. BMC Pregnancy and Childbirth. 2022 Apr; 22(1): 365. doi: 10.1186/s12884-022-04681-4. DOI: https://doi.org/10.1186/s12884-022-04681-4
Canning D, Shah IH, Pearson E, Pradhan E, Karra M, Senderowicz L, Bärnighausen T, Spiegelman D, Langer A. Institutionalizing postpartum intrauterine device (IUD) services in Sri Lanka, Tanzania, and Nepal: study protocol for a cluster-randomized stepped-wedge trial. BioMed Central Pregnancy and Childbirth. 2016 Dec; 16: 1-1. doi: 10.1186/s12884-016-1160-0. DOI: https://doi.org/10.1186/s12884-016-1160-0
Herculano TB, Surita FG, Juliato CR, Rehder PM. Comparison between two methods of the immediate post-placental insertion of copper intrauterine device in vaginal birth-a protocol for a randomized clinical trial. Trials. 2022 Dec; 23(1): 1053. doi: 10.1186/s13063-022-07041-x. DOI: https://doi.org/10.1186/s13063-022-07041-x
Khurshid N, Taing S, Qureshi A, Jan Khanyari I. Post-placental intrauterine device insertion versus delayed intrauterine device insertion: an observational study. The Journal of Obstetrics and Gynecology of India. 2020 Apr; 70: 145-51. doi: 10.1007/s13224-019-01299-z. DOI: https://doi.org/10.1007/s13224-019-01299-z
Muganyizi PS, Kimario G, Ponsian P, Howard K, Sethi M, Makins A. Clinical outcomes of postpartum intrauterine devices inserted by midwives in Tanzania. International Journal of Gynecology & Obstetrics. 2018 Sep; 143: 38-42. doi: 10.1002/ijgo.12603. DOI: https://doi.org/10.1002/ijgo.12603
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
