A STUDY ON EMPHASIS ON PROPER TECHNIQUE OF INSERTION AND REMOVAL OF COPPPER T AT A TERTIARY CARE CENTRE

The Intrauterine Contraceptive Device Copper T is used by more than 150 million women around the world, making it the most widely used reversible method of contraception. Copper T a very safe contraceptive method can be used for 10 years. Missing Copper T thread is a common complaint when it may be curled in or the Copper T might have expelled or migrated. Methods: It was cross sectional study collecting the data between June 2020 to December 2020. Data was collected from OPD, OT register and Inpatient registers. The objective was to ascertain the symptoms, insertion methods, investigations done and mode of retrieving missed Copper T. Results: There were 63 cases of missing Copper T thread, out of which, 33 patients were asymptomatic, Irregular vaginal bleeding in (19 patients) was commonest complaint, followed by abdominal pain in (10 patients). Pregnancy was detected in one patient. Transvaginal ultrasonography (TVS) detected intrauterine location of Copper T in 60 cases. X-ray abdomen erect was needed in 3 cases, out of which 2 cases detected myometrial impingement and piercing of Copper T with broken T limb and in 1 case Copper T was expelled. In 31 patients, Copper T was removed by artery forceps in OPD. In 17 cases, hysteroscopic Copper T removal was needed. Two cases with migrated Copper T underwent laparoscopy for retrieval of Copper T. One patient had to be converted to laparotomy for piercing of myometrium. Conclusion: Copper T thread can be missing most commonly with postpartum IUCD. Transvaginal ultrasound is first done in missing Copper T thread. When not visualized we go for an X-ray abdomen and pelvis. Hysteroscopic retrieval was attempted under anaesthesia in patients where Copper Tcould not be retrieved with artery forceps. Laparoscopy and laparotomy may be required as last attempt in migrated Copper Tcases.