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Tale of the Tails, the Missing Postpartum IUCD Strings

The Journal of Obstetrics and Gynecology of India volume 67, pages 202–207 (2017)Cite this article

Abstract

Introduction

Using an intrauterine device (IUD) is many times safer than pregnancy and more effective in preventing pregnancy than oral contraceptives, condoms, spermicidal, any barrier method, or natural family planning. Benefits of healthy timing and spacing of pregnancy are many. Postpartum contraception is becoming popular after introduction of PPIUCD services.

Objective

To study the incidence, management, clinical outcome of missing strings cases in post-placental and intra-cesarean IUCD.

Materials and Methods

This study was a retrospective observational study, carried out in the district of Balangir, Odisha, India. Status of women who had post-placental and intra-cesarean IUCD insertion in various institutions between January 2010 and December 2012 having follow-up as per the protocol was taken for the study. All the complications were recorded and studied. Incidence, clinical outcome, and management of missing strings were analyzed.

Results

Records of 1343 clients were studied. Six hundred and seventeen cases had failed to report for follow-up as per the study design. Seven hundred and twenty-six cases had follow-up as per the protocol. Of them, 36 had expulsion, and rest 690 cases were taken for the study. There were 209 missing strings at 3 months. At the end of the study, there was spontaneous descend in 138 cases. More than 50 % cases were asymptomatic. Ultrasonography was the method of diagnosis, and simple sounding of the uterus alone could also establish IUD in uterine cavity. Removal rate was higher in missing strings group, Continuation rate is higher in String visible group.

Conclusion

Post-placental intra-cesarean Copper T 380A insertion is a safe and effective method of reversible contraception; missing string is emerging as a potential distracter of its use. It is important that every user must be followed up and the providers must be competent in managing complication. Better after care in form of effective follow-up and complication management is needed to maintain popularity. Introduction of compensation scheme will also help improving the acceptance.

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Author information

Affiliations

  1. District Headquarters Hospital, Balangir, 767001, Odisha, India

    Sujnanendra Mishra

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  1. Sujnanendra Mishra
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Corresponding author

Correspondence to Sujnanendra Mishra.

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Ethical Statement

Author certify that he has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements.) that might pose a conflict of interest in connection with the submitted work.

Conflict of interest

None.

Additional information

Dr. Sujnanendra Mishra MD (OBGYN), is senior consultant.

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Mishra, S. Tale of the Tails, the Missing Postpartum IUCD Strings. J Obstet Gynecol India 67, 202–207 (2017). https://doi.org/10.1007/s13224-016-0940-9

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  • DOI: https://doi.org/10.1007/s13224-016-0940-9

Keywords

  • PPIUCD
  • Missing string
  • Expulsion
  • Management of missing thread
  • IUD retriever Hook
  • Alligator forceps