scholarly journals Determinants of uptake of post-partum intra-uterine contraceptive device among women delivering in a tertiary hospital, Odisha, India

Author(s):  
Srabani Pradhan ◽  
Jaya Singh Kshatri ◽  
Rishika Sen ◽  
Arpika Aparajita Behera ◽  
Radha Madhab Tripathy

Background: IUCDs are used by only two percent of the contraceptive users in India. There is a need for identifying the factors which influence the uptake of PPIUCD, so as to plan ways for increasing its usage. To determine the uptake and factors influencing the uptake of PPIUCD among the women delivering in a tertiary care hospital of OdishaMethods: This was a case control study conducted at the Obstetrics Department of M.K.C.G Medical College, Berhampur. All those who had agreed for and had undergone PPIUCD insertion were included in cases and those who did not undergo PPIUCD insertion were pooled into controls.Results: 94 cases and 188 controls were recruited. Significantly higher proportions of cases belonged to nuclear families, had one or more male child, did not want any future pregnancies, had heard about it prior to pregnancy and also had received counselling for the same during the antenatal period. The adjusted odds of uptake of PPIUCD in women having at least one male child is 10 (4.3-22.6) times that of mothers with no male children. The most common reasons told by controls for not taking up PPIUCD was disapproval from family members (42.6%), followed by fear of complication (33%) and preference for other methods of contraception (20.2%).Conclusions: In present study, we found that counselling in the antenatal period was a key point in increasing acceptance of post-partum IUCD. Desire for male child also influenced uptake of postpartum IUCD.

Author(s):  
Manimegalai R. ◽  
Suganthi R.

Background: NFHS (National Family Health Survey) 2005-2006 in India revealed that the contraceptive prevalence rate is 53.5%. 10% of all pregnancies are mistimed and 11% of all pregnancies are unwanted in India. Objective of present study was to compare the benefits and complications of postpartum IUCD insertion (PPIUCD) over interval IUCD insertion in a tertiary care hospital.Methods: It is a retrospective study conducted in the Department of Obstetrics and Gynecology, Govt. Mohan Kumaramangalam Medical College, Salem from 2009-2014. The cases of interval IUCD for the year 2009-2014 and PPIUCD cases for the year 2012-2014 both vaginal insertion and intracaesarean insertion were taken for study. Complications, benefits and reasons for removal were compared between the two groups.Results: The total number of cases of IUCD insertion significantly increased after the introduction of PPIUCD programme in 2012. The acceptance of IUCD insertion was steadily increasing after the introduction of PPIUCD even though the follow up of PPIUCD cases was less (32%). The rate of removal in patients who came for follow up was less in PPIUCD group (18%) compared to interval IUCD cases (57%) when the reason was menorrhagia. The most common reason for removal was menorrhagia in interval IUCD patients. Abdominal pain was the most common reason for removal in PPIUCD patients. The rate of expulsion was higher in PPIUCD (6%) compared to interval IUCD patients (<1%). No cases of perforation and no cases of pregnancy in situ were reported in PPIUCD cases during the study period. Even though the rate of infection and missing strings were higher in PPIUCD patients when compared to interval IUCD patients who came for follow up the number of women with infection in PPIUCD patients is less and easily managed with appropriate antibiotics.Conclusions: In India PPIUCD insertion soon after delivery is a safe, effective, reversible and reliable method of long term contraception. Both vaginal and intracaesarean insertions are safe, efficacious and convenient even though there are few complications which are easily manageable. There are no incidences of perforations, pregnancy in situ, ectopic pregnancy and low rates of infection. Hence PPIUCD is a promising approach to decrease the fertility rate in the field of family planning.


2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67


Author(s):  
Rupali Atmaram Gaikwad ◽  
Shrinivas N. Gadappa ◽  
Sonali S. Deshpande

Background: In this modern or scientific era even though women are working equally or one step ahead of men, in family planning decision they are still lagging behind. Postpartum period is very crucial for a woman especially for many of those belonging to the villages as this may be the only time she comes in contact with a health personnel and in a mood to listen health advice. Keeping this in mind, this crucial period was considered as opportunity to test the issue of awareness regarding contraception.Methods: We conducted a cross-sectional study in the department of obstetrics and gynecology of Govt medical college and hospital, Aurangabad between August 2016 to December 2016. A total 720 post-partum women were interrogated and counselled regarding various methods of contraception.Results: Only 55.69% were aware about various methods of contraception. Awareness was maximum for Sterilisation (91%) followed by Intrauterine contraceptive device (81%) and Oral contraceptive pills (41%). Women knew about contraception from health care system (45%) and mass media (36%). After counselling 97% patients ready to use.Conclusions: There is lack of awareness regarding contraception. Contraceptive services are to be strengthened by intergrating with antenatal sevices.


Author(s):  
Arpitha S. Ballu ◽  
Asha M. B.

Background: Cesarean delivery is a commonest obstetric surgical procedure performed. WHO stated that regional cesarean section rate should not exceed 10 to 15%. However in many countries cesarean delivery has increased steadily over years. Hence present study is conducted to analyze various indications of primary cesarean section in a tertiary hospital, with an aim to reduce cesarean section rate.Methods: This is a retrospective study conducted in Cheluvamba hospital, Mysore Medical College Research Institute, Mysore, which is a tertiary care centre. For a period of 6months from 1st June 2018 to 31st November 2018Inclusion criteria: All primary cesarean section done at Cheluvamba hospital during study period were included.Exclusion criteria: Previous cesarean section, patients with previous history of laparotomy done for any obstetric or gynecological cause were excluded.Results: During the study period there was 3799 number of cesarean section. Amongst these 983 cases were primary cesarean section done for varying indications. Hence the rate of cesarean section in our hospital is 25.87%. There were 40.3% cases of fetal distress, failed induction (13.6%), breech (10%), CPD (8%), IUGR with poor BPP (1.8%) Ante partum haemorrhage (3%), DTA (3.5%).Conclusions: From our study, we would conclude that rising trend in cesarean section is an alarming issue. Measures need to be taken to reduce cesarean delivery like Regular use of partograph, Judicious use of amniotomy, oxytocin with inducing agents, Expertization of skills to conduct instrumental vaginal delivery, which is a lost art in modern obstetrics.


Author(s):  
Santosh Khajotia ◽  
Kavita Choudhary ◽  
Moolchand Khichar ◽  
Manoj Gupta ◽  
Madhuri Sharma ◽  
...  

Introduction: Present study was conducted to evaluate the risk factor of PPH.  Methodology: Study group comprises of 100 females attending obstetrics and gynecology department in S.P. Medical College, Bikaner. Delivered women ? 28 weeks seen during the first hour of PPH with visual blood loss >500 ml in normal vaginal delivery and > 1000 ml during LSCS were included in the study.  Results: Out of 100 cases, 17(17%) had multiparity followed by 7(7%) each had previous LSCS and prolonged labor, 5(5%) each had multiple pregnancy and macrosomia, 3(3%) each had placenta previa and previous 2 LSCS, 2(2%) each had postdatism and precipitate labor and 1(1%) had breech. Conclusion: Multiparty was most common risk factor. Keywords: Hemorrhage, Post-partum, Risk factor


Author(s):  
Urvashi Barman Singh ◽  
Shakti Jain ◽  
Yashi Srivastava ◽  
Manisha Gupta ◽  
Meena Dayal

Background: Objective of this study was to calculate the maternal mortality rate in our hospital and to assess the epidemiological aspects and causes of maternal mortality to further analyse ways to reduce the maternal mortality rate (MMR).Methods: This was a retrospective analytical study done in the department of obstetrics and gynecology, MLN Medical College and District Women Hospital, Prayagraj over a time period of 10 years i.e., October 2009 to October 2019. Retrospective analysis and evaluation of the medical records and statistics was done to find out and collect specific causes of maternal deaths in the give time period.Results: There were 357 maternal deaths from October 2009 to October 2019. Maternal mortality rate in the study was calculated to be 498.42 per 1 lakh live births. Maximum deaths were in 21-30 years age group with multipara, unbooked and illiterate cases. Majority of the deaths reported were from direct causes of maternal mortality i.e., hemorrhage, hypertensive disorders and sepsis.Conclusions: In the selected hospitals, the mean maternal mortality rate in the study period was 498.42/100000 births. 71.4% had direct cause and 21.56% had indirect cause of maternal mortality several factors like regular antenatal visits, early identification of high-risk cases, timely referral, institutional deliveries, adequate post-partum care and follow-up can contribute to decrease the maternal mortality rate effectively.


2021 ◽  
pp. 44-46
Author(s):  
Sumit Ranjan Pramanick ◽  
Saumen Mandal ◽  
Bharat Chandra Mandi ◽  
Debarshi Jana

Introduction: 1 India's population has crossed one billion in the year 2000. In recent censes of 2011 it has reached 121 crores and it is estimated to 2 reach a gure of1.53 billion by 2050, making it the most populous country in the world . India is the rst country in the world to adopt an ofcial population policy and launch ofcial family planning programme way back in 1952, which remains the mainstay of family planning efforts. Aims and objectives: 1. To nd out the proportion of accepting the Post-Partum Intrauterine Contraceptive Device (PPIUCD) insertion among eligible women delivering at SSKM hospital. 2. To assess the complications of post placental &intra caesarean PPIUCD if any among these acceptors. 3. To determine the spontaneous expulsion rate of this contraceptive device. Materials and methods: All Adult ANC women attending SSKM hospital at Gynae OPD and as well as admitted in hospital wards or Labour Room who will full the inclusion criteria during data collection period. Conclusion: The study results, it can be concluded that PPIUCD in the eld of PPFP is a promising approach. Whatever may be the mode of delivery, PPIUCD is safe and efcacious in terms of safety and efcacy.


Author(s):  
Rekha Jain ◽  
Manisha Sharma ◽  
Shruti Gupta

Background: Intrauterine contraceptive device is a long acting, effective and reversible method of contraception. It can be inserted post placental during vaginal or LSCS delivery and within 48 hours of delivery.  This study evaluates the acceptance, safety, side effects and complications associated with immediate post-partum intrauterine contraceptive device (PPIUCD) insertion.Methods: The study was conducted at Hindu Rao Hospital and NDMC Medical College, Delhi for a period of 18 months. Patients admitted and delivered at Hindu Rao Hospital were counseled for PPIUCD, CuT 380 A / CuT 375 insertions and it was inserted within 10 minutes of delivery of placenta during vaginal delivery or LSCS or within 48 hours of delivery. Patients were followed at 6 weeks and then between 6 to 12 months of delivery for continuation, side effects or any complications.Results: After counseling 1253 (9.8%) patients agreed for PPIUCD insertion out of which 650 patients came for follow up. 46% women came for routine follow up while 54.06% came with one or the other complications. Missed thread was most common complications, followed by bleeding P/V and pain abdomen. Expulsion in 5.5% and CuT failure was seen in 0.92% women only. Removal of IUCD was done in 94 patients for one or other reasons. There was retention of PPIUCD in 84.5% while removal was done in 14.5% during period of 6 months to one year follow up. Missed thread was main cause of anxiety among acceptors.Conclusions: Immediate PPIUCD is safe and effective method of contraception with a high retention rate. Though acceptance in initial months was less but it gradually increased over time with increasing awareness, counseling of patients and training of health personnel.


Author(s):  
Vaishali Chaurasia ◽  
Sushruta Shrivastava

Background: The drastically increasing rate of caesarean section is a topic of constant worry and analysis throughout the world. In order to understand the degree to which caesarean section may be preventable, it is important to know why caesarean section are performed. This study is aimed to find out the rate of caesarean section at our institute, various indications of the procedure and complications related to them.Methods: This study was carried out retrospectively in the department of obstetrics and gynecology at Chirayu Medical College and Hospital, Bhopal. Study period was from January 2017 to December 2017. 500 cases of lower segment cesarean section were studied including both elective and emergency caesarean sections. Statistical analysis of age, parity, period of gestation, indications of LSCS and complications was done.Results: The rate of caesarean section came out to be 47.7%, which is far above recommended. Majority of patients (81.6%) were in 21-30 years age group; while the number of primary and repeat caesarean section were comparable (40.8% and 59.2%respectively). Commonest indication was previous LSCS (31.6%) followed by fetal distress (21.6%). Surgical site infection was present in 4.6% cases whereas, post-partum hemorrhage occurred in 5.8% cases. Three patients underwent obstetric hysterectomy and two cases of maternal mortality were reported among post LSCS patients.Conclusions: Increasing rates of caesarean section has contributed to maternal morbidity along with financial burden. Individualization of the indication and careful evaluation, following standardized guidelines, practice of evidenced-based obstetrics and audits in the institution, can help us limit rate of caesarean section.


Author(s):  
Subrata Samanta ◽  
Sujoy Dutta ◽  
Sudipta Samanta ◽  
Agrima Mullick

Background: Post-partum intra-uterine contraceptive device is one of the important methods of spacing to meet up the unmet need of family planning. The low complication rate, ease and certainty of insertion and one-time adoption advantages made it an option of family planning by Government of India. In the background of recent trends in family planning, the study aims to establish the efficacy and draw-backs of PP-IUCD among the clients in a tertiary care hospital of West Bengal.Methods: Prospective observational study on 1680 women during January 2016 to December 2016, where the PP-IUCD was given to the patients after vaginal delivery or Cesarean section and were followed up to 3 months.Results: During the study 1.37% patients did not turnup in either follow-up. The most common complication encountered was missing thread (4.64% at 6th week follow-up and 6.67% at 3rd month follow-up). Expulsion rate was much lower (2.02% at 6th week and 2.5% at 3rd month). Heavy bleeding per-vagina was in 1.55% at 6th week and 2.08% at 3rd month. Pain abdomen was .83% at 6th week and 1.67% at 3rd month. Incidence of perforation and failure was both nil at either follow-up. Dysmenorrhea was complained 2.44% at 6th week and 3.33% at 3rd month. Overall satisfaction rate at 6th week (86.05%) was higher than non-satisfaction (13.95%). This was also true for 3rd month where satisfaction rate (77.85%) was higher than non-satisfaction rate (22.15%).Conclusions: PP-IUCD appears to be a safe, efficacious, acceptable and accessible method of contraception.


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