scholarly journals Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

2021 ◽  
Vol 10 (1) ◽  
pp. 36
Author(s):  
Quratulain Shabbir ◽  
Amna Usman ◽  
Attiya Yasmeen ◽  
Humaira Zafar ◽  
Falak Naz ◽  
...  
Keyword(s):  
Gestational Age ◽  
Post Partum ◽  
Healthy Woman ◽  
Uterine Cavity ◽  
World Health ◽  
Contraceptive Device ◽  
Intrauterine Contraceptive ◽  
Post Placental ◽  
Health Organization

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.  

scholarly journals Immediate post placental insertion of intrauterine contraceptive device at caesarean delivery: a prospective study

2020 ◽  
Vol 9 (6) ◽  
pp. 2244
Author(s):  
Sravani Mukka ◽  
Madhavi Y.
Keyword(s):  
Family Planning ◽  
Prospective Study ◽  
Post Partum ◽  
Unmet Need ◽  
Intrauterine Contraceptive Device ◽  
Efficacy Rate ◽  
Contraceptive Device ◽  
Intrauterine Contraceptive ◽  
A Prospective Study

Background: In India almost 65% of the women have an unmet need for family planning in the first postpartum year. Increasing rates of institutional deliveries creates an opportunity for providing quality post-partum family planning services. Post-partum Intrauterine contraceptive device (PPIUCD), a form of long acting reversible contraception (LARC) is one of the most affective and safest method available. The present study aims at evaluating the safety, efficacy, rate of acceptance and rate of discontinuation of Intra caesarean inserted contraceptive device Copper T-380A.Methods: This was a prospective study conducted at ESIC Medical College, Sanathnagar in women delivered by caesarean section during the period between March 2018 to February 2019. Recruitment was done based on the WHO medical eligibility criteria (MEC) for PPIUCD and also their willingness to participate in the study. Follow-up visits were scheduled at 6 weeks, 3 months and 6 months.Results: Of the 265 women fulfilling the WHO MEC, 180 (67.92%) were willing to participate in the study. Total acceptance rate was 67.7%. Majority of them belonged to the age group 21-30 years (80%) and para 2 (53.88). 93.3% of the women were literates. 12 (6.66%) cases lost to follow up and the complications were studied in the rest 168 women. During follow up -38.69% had missing strings, 12.5% menstrual disturbances, 4.76% abdominal pain and spontaneous expulsion in 4.1%. No cases of perforation and pregnancy were reported. Total continuation rate was 84%.Conclusions: PPIUCD is a safe and convenient option of contraception with low expulsion rates and high continuation rates.

324 Cases of Misplaced IUCD — A 5-Year Study

2003 ◽  
Vol 33 (1) ◽  
pp. 11-12 ◽  
Author(s):  
Meenakshi Barsaul ◽  
Neeraj Sharma ◽  
Krishna Sangwan
Keyword(s):  
Developing Countries ◽  
Family Planning ◽  
Uterine Cavity ◽  
Cervical Canal ◽  
Contraceptive Device ◽  
Primary Health Centres ◽  
Intrauterine Contraceptive ◽  
Proper Training ◽  
And Migration

Copper-T remains the mainstay of family planning measures in developing countries but is associated with serious complications like bleeding, perforation and migration to adjacent organs or omentum. Patients with misplaced intrauterine contraceptive device (IUCD) may present with pregnancy or lost strings or may remain asymptomatic for years. In our series of 324 cases with misplaced IUCD1; in 258 (79.93%) cases copper-T was found in the uterine cavity and in 47 cases (14.51%) it was removed from cervical canal. In only 18 cases (5.56%), it was translocated and of these 66.67% were inserted at primary health centres. Laparoscopic retrieval was successful in 61.11% cases. Endoscopy thus helps in the localization and retrieval of misplaced IUCDs. A regular follow up of IUCDs for visible threads would help in earlier detection of misplaced IUCDs. Proper training of paramedical staff is mandatory in developing countries to provide safe and better family planning services.

scholarly journals Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 1916
Author(s):  
Rekha Jain ◽  
Manisha Sharma ◽  
Shruti Gupta
Keyword(s):  
Side Effects ◽  
Retention Rate ◽  
Post Partum ◽  
Tertiary Care ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Intrauterine Contraceptive ◽  
Reversible Method

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.

Unusual Complication of Intrauterine Contraceptive Device

2016 ◽  
Vol 8 (3) ◽  
pp. 243-245
Author(s):  
Namita Agarwal ◽  
Brijesh K Agarwal
Keyword(s):  
New York ◽  
Intrauterine Contraceptive Device ◽  
World Health ◽  
Unusual Complication ◽  
Contraceptive Device ◽  
Vesical Calculus ◽  
Contraceptive Devices ◽  
Intrauterine Contraceptive ◽  
Health Organization ◽  
Intrauterine Contraceptive Devices

ABSTRACT Intrauterine foreign bodies have been used in animals as a contraceptive since times immemorial. The use of pebbles in camels as a contraceptive has been reported in Arabs. Intrauterine contraceptive devices (IUCDs) have been used since 1962 when the first International Conference of Population Council, New York reported encouraging data on Margulies coil and Lippes loop as IUCDs. According to the World Health Organization, IUCDs are the second most widely used reversible contraceptive method after voluntary female sterilization. Intrauterine contraceptive devices have undergone extensive evolution from Grafenberg ring to Ota ring, Margulies coil, Lippes loop, Birnberg bows, Saf T-coil followed by Cu T 200, Cu 7, Multiload Cu 250/375, Cu T 380 Ag, Cu T 380 S [slimline]. Hormonereleasing IUCDs were developed in 1973. Ombrelle 250/380 and FlexiGard are the latest in this series. The common complications encountered with IUCD insertion are pelvic infections, infertility, the risk of both intrauterine and extrauterine pregnancy, pain, altered bleeding pattern, expulsion of the device, and its migration. Migration of IUCD into the bladder has been rarely reported in the literature. The authors report an unusual case of a secondary vesical calculus formed around a migrated IUCD. How to cite this article Agarwal N, Agarwal BK. Unusual Complication of Intrauterine Contraceptive Device. J South Asian Feder Obst Gynae 2016;8(3):243-245.

scholarly journals Comparative study of IUCD inserted intracesarean and after vaginal delivery

2018 ◽  
Vol 7 (5) ◽  
pp. 2007
Author(s):  
Archana Goyal ◽  
Rekha Wadhwani
Keyword(s):  
Removal Rate ◽  
Post Partum ◽  
Intrauterine Device ◽  
Uterine Cavity ◽  
Cost Effective ◽  
High Rate ◽  
Contraceptive Device ◽  
Expulsion Rate ◽  
Intrauterine Contraceptive

Background: In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective, long-term contraception such as intrauterine device (IUD) in post-partum women. The present study was planned to evaluate the safety and efficacy of immediate post-partum IUD insertion in women delivering vaginally or by caesarean section.Methods: The women recruited had CuT 380A insertion immediately after delivery of placenta in vaginal or caesarean delivery. Women having post-partum haemorrhage (PPH), anaemia, pre-labour rupture of membranes >18 h, obstructed labour and distorted uterine cavity by fibroid or by congenital malformation were excluded from the study. The women were followed up at 6 weeks after delivery.Results: A total of 500 women were included in the study. The present study shows that expulsion rate was more in postplacental insertion group i.e. 13.2% while among intracaesarean group it was 6.8% and this difference was statistically significant. Removal rate of PPIUCD (Post-partum Intrauterine Contraceptive device) was higher in postplacental insertion i.e.43 (17.2%) cases whereas in intracaesarean insertion removal rate was 8.4%. Most common cause of removal of PPIUCD in our study was pelvic pain and menstrual disturbances.Conclusions: Thus, from our study it is concluded that PPIUCD is safe, convenient, cost effective, reversible and long-term birth spacing method. It should be part of a maternal/newborn/reproductive health package.

scholarly journals Programme for Harmonization to the International Scale in Latin America for BCR-ABL1 quantification in CML patients: findings and recommendations

2020 ◽  
Vol 58 (12) ◽  
pp. 2025-2035
Author(s):  
María Sol Ruiz ◽  
María Belén Sánchez ◽  
Yuly Masiel Vera Contreras ◽  
Evangelina Agrielo ◽  
Marta Alonso ◽  
...  
Keyword(s):  
Latin America ◽  
Myeloid Leukemia ◽  
World Health ◽  
Molecular Response ◽  
Limit Of Quantification ◽  
International Scale ◽  
Deep Molecular Response ◽  
Health Organization ◽  
First Time

AbstractObjectivesThe quantitation of BCR-ABL1 mRNA is mandatory for chronic myeloid leukemia (CML) patients, and RT-qPCR is the most extensively used method in testing laboratories worldwide. Nevertheless, substantial variation in RT-qPCR results makes inter-laboratory comparability hard. To facilitate inter-laboratory comparative assessment, an international scale (IS) for BCR-ABL1 was proposed.MethodsThe laboratory-specific conversion factor (CF) to the IS can be derived from the World Health Organization (WHO) genetic reference panel; however, this material is limited to the manufacturers to produce and calibrate secondary reference reagents. Therefore, we developed secondary reference calibrators, as lyophilized cellular material, aligned to the IS. Our purpose was both to re-evaluate the CF in 18 previously harmonized laboratories and to propagate the IS to new laboratories.ResultsOur field trial including 30 laboratories across Latin America showed that, after correction of raw BCR-ABL1/ABL1 ratios using CF, the relative mean bias was significantly reduced. We also performed a follow-up of participating laboratories by annually revalidating the process; our results support the need for continuous revalidation of CFs. All participating laboratories also received a calibrator to determine the limit of quantification (LOQ); 90% of them could reproducibly detect BCR-ABL1, indicating that these laboratories can report a consistent deep molecular response. In addition, aiming to investigate the variability of BCR-ABL1 measurements across different RNA inputs, we calculated PCR efficiency for each individual assay by using different amounts of RNA.ConclusionsIn conclusion, for the first time in Latin America, we have successfully organized a harmonization platform for BCR-ABL1 measurement that could be of immediate clinical benefit for monitoring the molecular response of patients in low-resource regions.

scholarly journals Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Ponsian Patrick Paul ◽  
Anita Makins
Keyword(s):  
Service Providers ◽  
International Federation ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Gynecology And Obstetrics ◽  
Intrauterine Contraceptive ◽  
The Difference

Abstract Background The insertion of Intrauterine Contraceptive Device (PPIUD) for the purpose of contraception immediately after delivery is becoming popular in countries where the use of IUD for contraception has been extremely low. Since 2015, Tanzania implemented the initiative by the International Federation of Gynecology and Obstetrics (FIGO) to institutionalize PPIUD. As a result of capacity building and information delivery under the initiative, there have been increased uptake of the method. Working in this context, the focus of the study was to generate evidence on the effect of TCu380A IUD on amount and duration of lochia and equip service providers with evidence-based knowledge which can help them in counselling their PPIUD clients. Objective Establish impact of postpartum TCu380A on amount and duration of lochia. Methods A prospective cohort study of delivered women in two teaching hospitals in Tanzania with immediate insertion of TCu380A or without use of postpartum contraception in 2018. TCu380A models; Optima (Injeflex Co. Brazil) and Pregna (Pregna International, Chakan, India) were used. Follow-up was done by weekly calls and examination at 6th week. Lochia was estimated by Likert Scale 0–4 relative to the amount of lochia on the delivery day. An estimated 250 women sample (125 each group) would give 80% power to detect a desired 20% difference in the proportion of women with prolonged lochia discharges among the Exposed and Unexposed groups. Data analysis was by SPSS. Results Two hundred sixty women were analysed, 127 Exposed and 133 Unexposed. Medical complaints were reported by 41 (28.9%) Exposed and 37 Unexposed (27.8%), p = 0.655. Lack of dryness by end of 6th week was to 31 (23.3%) Exposed and 9 (7.1%) Unexposed, p < 0.001. Exposed had higher weekly mean lochia scores throughout with the difference most marked in 5th week (3.556 Versus 2.039, p < 0.001) and 6th week (1.44 Versus 0.449, p<0.001). Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ needs to be informed about the possibility of delayed dryness of lochia at time of counseling are discussed.

scholarly journals Trials and Tribulations: mHealth Clinical Trials in the COVID-19 Pandemic

2021 ◽  
Author(s):  
Praveen Indraratna ◽  
Uzzal Biswas ◽  
Jennifer Yu ◽  
Guenter Schreier ◽  
Sze-Yuan Ooi ◽  
...  
Keyword(s):  
Decompensated Heart Failure ◽  
Hospital Staff ◽  
Outpatient Setting ◽  
World Health ◽  
Randomised Control Trial ◽  
Contact Method ◽  
Model Of Care ◽  
Coronary Syndrome ◽  
Health Organization

Introduction: Mobile phone-based interventions in cardiovascular disease are growing in popularity. A randomised control trial (RCT) for a novel smartphone app-based model of care, named TeleClinical Care - Cardiac (TCC-Cardiac), commenced in February 2019, targeted at patients being discharged after care for an acute coronary syndrome or episode of decompensated heart failure. The app was paired to a digital sphygmomanometer, weighing scale and a wearable fitness band, all loaned to the patient, and allowed clinicians to respond to abnormal readings. The onset of the COVID-19 pandemic necessitated several modifications to the trial in order to protect participants from potential exposure to infection. The use of TCC-Cardiac during the pandemic inspired the development of a similar model of care (TCC-COVID), targeted at patients being managed at home with a diagnosis of COVID-19. Methods: Recruitment for the TCC-Cardiac trial was terminated shortly after the World Health Organization announced COVID-19 as a global pandemic. Telephone follow-up was commenced, in order to protect patients from unnecessary exposure to hospital staff and patients. Equipment was returned or collected by a ‘no-contact’ method. The TCC-COVID app and model of care had similar functionality to the original TCC-Cardiac app. Participants were enrolled exclusively by remote methods. Oxygen saturation and pulse rate were measured by a pulse oximeter, and symptomatology measured by questionnaire. Measurement results were manually entered into the app and transmitted to an online server for medical staff to review. Results: A total of 164 patients were involved in the TCC-Cardiac trial, with 102 patients involved after the onset of the pandemic. There were no hospitalisations due to COVID-19 in this cohort. The study was successfully completed, with only three participants lost to follow-up. During the pandemic, 5 of 49 (10%) of patients in the intervention arm were readmitted compared to 12 of 53 (23%) in the control arm. Also, in this period, 28 of 29 (97%) of all clinically significant alerts received by the monitoring team were managed successfully in the outpatient setting, avoiding hospitalisation. Patients found the user experience largely positive, with the average rating for the app being 4.56 out of 5. 26 patients have currently been enrolled for TCC-COVID. Recruitment is ongoing. All patients have been safely and effectively monitored, with no major adverse clinical events or technical malfunctions. Patient satisfaction has been high. Conclusion: The TCC-Cardiac RCT was successfully completed despite the challenges posed by COVID-19. Use of the app had an added benefit during the pandemic as participants could be monitored safely from home. The model of care inspired the development of an app with similar functionality designed for use with patients diagnosed with COVID-19.

scholarly journals Determinants of Method Switching among Social Franchise Clients Who Discontinued the Use of Intrauterine Contraceptive Device

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Waqas Hameed ◽  
Syed Khurram Azmat ◽  
Moazzam Ali ◽  
Wajahat Hussain ◽  
Ghulam Mustafa ◽  
...  
Keyword(s):  
User Satisfaction ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Contraceptive Usage ◽  
Social Franchise ◽  
Intrauterine Contraceptive ◽  
Contraceptive Discontinuation

Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating contraceptive usage altogether.Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine (9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant.Results. We found that 39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD insertion.Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor clients, and user satisfaction.

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