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

2020 ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Patrick Ponsian Paul ◽  
Anita Makins
Keyword(s):  
Cohort Study ◽  
Service Providers ◽  
International Federation ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Gynecology And Obstetrics ◽  
Intrauterine Contraceptive

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 275 women were analysed, 142 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 32 (22.5%) Exposed and 8 (6.0%) Unexposed, p<0.001. Exposed had higher weekly mean lochia scores throughout with varience most marked in week 5 (F=3.818, p<0.001) and week 6 (F=2.949, p=0.004). Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of PPIUD clients’ need to be informed about the possibility of delayed dryness of lochia at the time of counseling are discussed.

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

2020 ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Patrick Ponsian 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 BackgroundThe 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. ObjectiveEstablish 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 260 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 Impact of immediate postpartum insertion of TCu380A on the quantity and duration of lochia discharges in Tanzania

2020 ◽  
Author(s):  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
France John Rwegoshora ◽  
Patrick Ponsian Paul ◽  
Anita Makins
Keyword(s):  
Service Providers ◽  
Teaching Hospitals ◽  
Evidence Based ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Intention To Treat ◽  
Gynecology And Obstetrics ◽  
Excess Amount ◽  
Intrauterine Contraceptive

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 so as to minimize unnecessary interventions and method discontinuation.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 6 th 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 difference. Data analysis was by intention to treat using SPSS.Results 275 women were analysed, 142 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 6 th week was to 32 (22.5%) exposed and 8 (6.0%) unexposed, p<0.001. Exposures had higher weekly mean lochia scores throughout with varience most marked in week 5 (F=3.818, p<0.001) and week 6 (F=2.949, p=0.004).Conclusion PPIUD is associated with increased amount of lochia and slows progression to dryness within 6 weeks of delivery. The implications of excess amount and duration of lochia in care of PPIUD clients are discussed.

scholarly journals Twelve-month complications, continuation and failure rate of CuT380A when used for immediate postpartum contraception in Tanzania: A cohort study

2020 ◽  
Author(s):  
France John Rwegoshora ◽  
Projestine Selestine Muganyizi ◽  
Grasiana Festus Kimario ◽  
Ponsian Patrick Paul ◽  
Anita Makins
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Failure Rate ◽  
Outcome Variable ◽  
Contraceptive Device ◽  
Continuation Rate ◽  
Postpartum Contraception ◽  
Phone Calls ◽  
Gynecology And Obstetrics ◽  
One Year

Abstract Background Less than 1% of married women in Tanzania use an Intrauterine Contraceptive Device (IUD) for the purpose of contraception. An initiative by the International Federation of Gynecology and Obstetrics (FIGO) has been on since 2015 resulting in escalated method uptake in implementing hospitals. This study investigates failure rate, complications, and risk factors for one-year continuation of TCu380A IUD when used for immediate postpartum contraception under the initiative in Tanzania Methodology A prospective cohort study of women who had TCu380A insertion within 48 hours of delivery in 6 hospitals in Tanzania between 1 st December 2017 and 18 th April 2018 was conducted. Immediate, face to face post insertion interviews were made with 1114 clients and later at the beginning of 13 th month through phone calls. PPIUD continuation status, complications, duration of time they stayed with the IUD and the currently used method if PPIUD was discontinued were enquired. The outcome variable was PPIUD continuation at one year of IUD insertion. Data were analyzed using Statistical Product and Service Solutions software (SPSS) for Windows version 20 (IBM SPSS Statistics, Chicago, IL, USA). Results In total 511(45.8%)clients had consented and availed to complete the one-year follow-up. Out of these, 440 still had IUD by end of 12 months, giving a one-year continuation rate of 86.1%. Most (63%) IUD discontinuations occurred in the period between 7 th week and 6 months of insertion. One-year method expulsion rate was 2.1%. There was one reported pregnancy that gives a method failure rate of about 2 per 1000. The independent risk factors in favor of method continuation at one year were absence of medical or social problem, adolescence (16-24 years), and delivery by Cesarean section. Conclusions The continuation rate when CuT380A is used for immediate postpartum contraception is high and with low failure rate. Some medical and social factors are important for method continuation, hence the need to consider in training, counselling and advocacy.

A Comparative Study of Manual vs Instrumental Intracesarean Postpartum Intrauterine Contraceptive Device

2017 ◽  
Vol 9 (1) ◽  
pp. 25-28
Author(s):  
Parneet Kaur ◽  
Khushpreet Kaur ◽  
Beant Singh ◽  
Manjit K Mohi ◽  
N Chakheni
Keyword(s):  
Side Effects ◽  
Comparative Study ◽  
Intrauterine Contraceptive Device ◽  
Contraceptive Device ◽  
Continuation Rate ◽  
Postpartum Contraception ◽  
Group I ◽  
Intrauterine Contraceptive ◽  
Group Ii

ABSTRACT Aims and objectives The main objective of the study was to compare the two different methods of intracesarean insertion of postpartum intrauterine contraceptive device (PPIUCD), i.e., manual vs instrumental, and to study the effectiveness, safety, and continuation rate of intracesarean PPIUCD as a contraceptive method. Materials and methods A total of 100 subjects undergoing lower (uterine) segment cesarean section (LSCS) were enrolled for the study. In group I (n = 50), Cu-T 380A was inserted manually and in group II (n = 50), Cu-T 380A was inserted with a PPIUCD forceps. After checking for the inclusion and exclusion criteria and proper counseling, written consent was obtained and subjects were enrolled for the study. All the subjects were followed up for 3 months either clinically or telephonically. All the complaints, side effects, complications, and findings of both the groups were compared and analyzed. Results The continuation rate after the period of follow-up was 94% in group I and 92% in group II. There was only one case (2%) of expulsion in group II. A total of 3 (6%) subjects in group I and 3 (6%) of the subjects in group II got PPIUCD removed for various reasons. There was no case of infection, perforation, or contraceptive failure. Conclusion Intracesarean PPIUCD is an effective method of postpartum contraception and both the methods (manual and instrumental) are equally effective with minimum side effects and complications and good acceptability by the clients. How to cite this article Chakheni N, Kaur P, Kaur K, Singh B, Mohi MK. A Comparative Study of Manual vs Instrumental Intracesarean Postpartum Intrauterine Contraceptive Device. J South Asian Feder Obst Gynae 2017;9(1):25-28.

scholarly journals Comparison of Depot Medroxyprogesterone Acetate and Postpartum Intrauterine Contraceptive Device in a Teaching Institute of Rural Bengal: A Longitudinal Cohort Study

2021 ◽  
Author(s):  
Sougata Kumar Burman ◽  
Jayeeta Mukherjee ◽  
Ranita Roy Chowdhury ◽  
Soumen Deb
Keyword(s):  
Cohort Study ◽  
Post Partum ◽  
Statistical Significance ◽  
Intrauterine Contraceptive Device ◽  
Longitudinal Cohort Study ◽  
P Value ◽  
Contraceptive Device ◽  
Postpartum Contraception ◽  
Longitudinal Cohort ◽  
Intrauterine Contraceptive

Introduction: Contraception is one of the proximate determinants of fertility and the most important predictor of fertility transition. Depot Medroxy Progesterone Acetate (DMPA) and Intrauterine contraceptive device share some common features- both are Long Acting and Reversible Contraceptives (LARC), but the mechanisms are different. DMPA is a noninvasive, hormonal manoeuvre IUCD is an invasive, nonhormonal one. Aim: To compare the acceptance and reasons for refusal or non-compliance between DMPA and Postpartum Intrauterine Contraceptive (PPIUCD). Materials and Methods: A longitudinal cohort study was done in which total of 110 post partum women (55 in each group) using either DMPA or IUCD were selected randomly and were interviewed and followed up for minimum of six months. Data (variables- number of candidates accepting or refusing PPIUCD or DMPA) from the questionnaires were entered in Microsoft Office Excel 2007 and was transferred to IBM SPSS software, version 20.0 (SPSS Inc. Chicago, IL, USA). Pearson’s Chi-square test was used for variables and p-values were calculated using to find out the statistical significance of the variables and p-value <0.05 was considered statistically significant. Results: The overall acceptance of DMPA (87.3%) was found to be much more than that of PPIUCD (63.6%). In respect to different age groups, the acceptances of both PPIUCD and DMPA were significantly higher in women of age group 21-25. In respect to parity, acceptance of PPIUCD was more in women with one child, whereas the acceptances of DMPA were almost similar in women with either one or two children. Women using PPIUCD, 36.4% refused to continue with the method, whereas only 12.7% of DMPA users refused further injections, the main reason for both the groups being the same irregular bleeding. Conclusion: The acceptance as well as compliance of DMPA as a method of postpartum contraception is much better than PPIUCD in women of this part of part of rural Bengal.

scholarly journals Electronic cigarettes in standard smoking cessation treatment by tobacco counselors in Flanders: E-cigarette users show similar if not higher quit rates as those using commonly recommended smoking cessation aids

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Karolien Adriaens ◽  
Eline Belmans ◽  
Dinska Van Gucht ◽  
Frank Baeyens
Keyword(s):  
Smoking Cessation ◽  
Cohort Study ◽  
Replacement Therapy ◽  
Electronic Cigarettes ◽  
Evidence Based ◽  
Smoking Abstinence ◽  
Smoking Cessation Treatment ◽  
Cessation Treatment ◽  
Point Prevalence Abstinence

Abstract Background This interventional-cohort study tried to answer if people who smoke and choose an e-cigarette in the context of smoking cessation treatment by tobacco counselors in Flanders are achieving smoking abstinence and how they compare to clients who opt for commonly recommended (or no) aids (nicotine replacement therapy, smoking cessation medication). Methods Participants were recruited by tobacco counselors. They followed smoking cessation treatment (in group) for 2 months. At several times during treatment and 7 months after quit date, participants were asked to fill out questionnaires and to perform eCO measurements. Results One third of all participants (n = 244) achieved smoking abstinence 7 months after the quit date, with e-cigarette users having higher chances to be smoking abstinent at the final session compared to NRT users. Point prevalence abstinence rates across all follow-up measurements, however, as well as continuous and prolonged smoking abstinence, were similar in e-cigarette users and in clients having chosen a commonly recommended (or no) smoking cessation aid. No differences were obtained between smoking cessation aids with respect to product use and experiences. Conclusions People who smoke and choose e-cigarettes in the context of smoking cessation treatment by tobacco counselors show similar if not higher smoking cessation rates compared to those choosing other evidence-based (or no) smoking cessation aids.

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.

A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

2021 ◽  
pp. 1-3
Author(s):  
Shweta Pathak ◽  
Manaswita Samanta ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Clinical Outcomes ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Contraceptive Device ◽  
Obstetrics And Gynaecology ◽  
Vaginal Deliveries ◽  
Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

scholarly journals An Uncommon Site of Streptococcus pneumoniae Colonization Leading to Recurrent Pneumococcal Disease

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Parham Sendi ◽  
Eva Maria Moser Schaub ◽  
Konstantinos Nirgianakis ◽  
Lucy J. Hathaway ◽  
Pascal Bittel ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Pneumococcal Vaccine ◽  
Pneumococcal Disease ◽  
Contraceptive Device ◽  
Source Of Infection ◽  
Vaginal Colonization ◽  
Intrauterine Contraceptive ◽  
Conjugate Pneumococcal Vaccine ◽  
Antibody Levels

Abstract This report describes a case of relapsing pneumococcal peritonitis. The postulated source of infection was vaginal colonization and secondary adherence of pneumococci to an intrauterine contraceptive device. After immunization with a conjugate pneumococcal vaccine, her antibody levels were observed. She remained infection free at the 2-year follow-up investigation.

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