PPIUCD is an effective method of family planning .It is reversible , convenient and safe.
It is applied postplacental (within 10 minutes of normal vaginal delivery ) , immediate (within 48 hrs of normal delivery ) , intracaesarean or post abortal.
Chances of perforation are less within 48 hrs of delivery as the wall of uterus is thick.
It can be applied in systemic diseases like hypertension , epilepsy , tuberculosis and diabetes etc where pills, injectables and ligation has its limitations.
In Govt sectors OPDs are overloaded , running short of manpower so it reduces certain amount of burden by avoiding doing urine test for pregnancy and boiling the instruments again and again so saving the time.
The only disadvantage being the high expulsion rate , the study of the expulsion rate was done for 4 consecutive months.
Study was done to see the actual expulsion rate by inserting the IUCD by untranied staff and trained staff. Comparison was also done between manually placed IUCD and placed by kelly's forceps.
Intracaesarean cases were also studied for the expulsion rate
Training for its insertion was given under NRHM and service provider was given a fixed amount per case.
The comparison of the expulsion rate was done before and after the training
Kelly’s forceps were provided and all the LMO’s and GNM.s of the Government hospital and from CHCs PHCs were trained theoretically as well as practically by the Gynecologist for three months.
In intracaesarean IUCD the expulsion rate was nil .The follow up was done for 6-8 weeks but not even a single case reported missing thread or heavy bleeding or any other side effect.
When it was inserted manually before training the expulsion rate was high and when applied by the trained staff with proper use of kelly's forceps , expulsion rate was less.
Manually placed IUCD showed higher expulsion rate as compared to IUCD placed by kelly’s frceps.
Three consecutive months were studied for the expulsion rate .
There was marked difference between the expulsion rate before and after training
Comparison between manually placed and using kellys forceps was also done . Expulsion was higher in the IUCD placed manually and by untrained staff
The IUCD did not reach the fundus when applied manually by untrained staff . It was already lying in the cervix or vagina causing false datas for the expulsion rate.
.The expulsion rate was less when applied using kellys forcep and under doctor's supervision by trained staff and it was true expulsion rate.
In LSCS it was directly put on fundus by gynaecologist , expulsion rate was nil.