FIGO postpartum intrauterine device initiative: Complication rates across six countries

Anita Makins; Neda Taghinejadi; Maya Sethi; Kazuyo Machiyama; Projestine Munganyizi; Elly Odongo; Hema Divakar; Parveen Fatima; Kusum Thapa; Gamini Perera; Sabaratnam Arulkumaran

doi:10.1002/ijgo.12600

journal article Open Access Sep 01, 2018

FIGO postpartum intrauterine device initiative: Complication rates across six countries

Anita Makins Neda Taghinejadi Maya Sethi Kazuyo Machiyama Projestine Munganyizi Elly Odongo Hema Divakar Parveen Fatima Kusum Thapa Gamini Perera Sabaratnam Arulkumaran

International Journal of Gynecology & Obstetrics Vol. 143 No. S1 pp. 20-27 · Wiley

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Abstract

AbstractObjectiveTo record and analyze complication rates following postpartum intrauterine device (PPIUD) insertion in 48 hospitals in six countries: Sri Lanka, India, Nepal, Bangladesh, Tanzania, and Kenya.MethodsHealthcare providers were trained in counselling and insertion of PPIUD via a training‐the‐trainer model. Data were collected on methodology, timing, cadre of staff providing care, and number of insertions. Data on complications were collected at 6‐week follow‐up. Statistical analysis was performed to elucidate factors associated with increased expulsion and absence of threads.ResultsFrom May 2014 to September 2017, 36 766 PPIUDs were inserted: 53% vaginal and 47% at cesarean delivery; 74% were inserted by doctors. Follow‐up was attended by 52%. Expulsion and removal rates were 2.5% and 3.6%, respectively. Threads were not visible in 29%. Expulsion was less likely after cesarean insertion (aOR 0.33; 95% CI, 0.26–0.41), following vaginal insertion at between 10 minutes and 48 hours (aOR 0.59; 95% CI, 0.42–0.83), and when insertion was performed by a nurse (aOR 0.33; 95% CI, 0.22–0.50).ConclusionPPIUD has low complication rates and can be safely inserted by a variety of trained health staff. Given the immediate benefit of the one‐stop approach, governments should urgently consider adopting this model.

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References

Details

Published: Sep 01, 2018
Vol/Issue: 143(S1)
Pages: 20-27
License: View

Authors

A

Anita Makins

International Federation Gynecology and Obstetrics London UK; Oxford University Hospitals NHS Foundation Trust Oxford UK

N

Neda Taghinejadi

Oxford University Hospitals NHS Foundation Trust Oxford UK

M

Maya Sethi

International Federation Gynecology and Obstetrics London UK

K

Kazuyo Machiyama

London School of Hygiene and Tropical Medicine London UK

P

Projestine Munganyizi

Association of Gynaecologists and Obstetricians of Tanzania Dar es Salaam Tanzania

E

Elly Odongo

Kenya Obstetrical and Gyanecological Society Nairobi Kenya

H

Hema Divakar

Federation of Obstetric and Gynecological Societies of India Mumbai India

P

Parveen Fatima

Obstetrics and Gynecology Department Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh

K

Kusum Thapa

Nepal Society of Obstetricians and Gynaecologists Kathmandu Nepal

G

Gamini Perera

Sri Lanka College of Obstetricians and Gynaecologists Colombo Sri Lanka

S

Sabaratnam Arulkumaran

International Federation Gynecology and Obstetrics London UK; St George's University of London London UK

Funding

FIGO initiative funded by anonymous donors

Cite This Article

Anita Makins, Neda Taghinejadi, Maya Sethi, et al. (2018). FIGO postpartum intrauterine device initiative: Complication rates across six countries. International Journal of Gynecology & Obstetrics, 143(S1), 20-27. https://doi.org/10.1002/ijgo.12600

FIGO postpartum intrauterine device initiative: Complication rates across six countries

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