scholarly journals Outcome Of Immediate PPIUCD At Follow Up Visit In Women At A Tertiary Care Hospital In Karachi, Pakistan

2018 ◽  
Vol 09 (01) ◽  
pp. 43-47
Author(s):  
Sadia Suboohi ◽  
Sughra Abbasi ◽  
Saba Pario
Keyword(s):  
General Hospital ◽  
Vaginal Bleeding ◽  
Vaginal Discharge ◽  
Post Partum ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Abnormal Vaginal Discharge

Objective: To evaluate the outcome of Immediate Post Partum Intrauterine Contraceptive device (PPIUCD) insertion among married women of reproductive age at a tertiary care Creek General Hospital, Karachi, Pakistan. Study Design: Prospective Interventional study. Methodology: The clinical study was conducted in department of Obstetrics & Gynaecology, Creek General hospital Karachi from August 2015 to July 2016. One hundred and twenty five women were selected for immediate PPIUCD insertion, however the result was analysed for hundred women as twenty five were lost to follow-up. PPIUCD was inserted within 10 minutes of delivery of placenta. Follow up was done at 6 weeks, the primary outcome measures were the clinical outcomes in terms of safety (irregular vaginal bleeding, abnormal vaginal discharge, infection and perforation) and efficacy (un-descended IUCD strings, expulsion, discontinuation and pregnancy). The results were analyzed by SPSS data analysis software (IOBM). Results: Among hundred women in whom PPIUCD was inserted and returned for follow-up, majority (44%) were in age group 26-30 years; around 52% had primary or less education, and considerably high (84%) belonged to the low socio economic status. Moreover, majority (46 %) had 3 or more alive children. Importantly, 73% women had IUCD inserted after vaginal delivery. As safety was evaluated, irregular vaginal bleeding was observed in 15%, abnormal vaginal discharge (20%), infection (11%), abdominal pain (4%) and perforation in only 1% of cases. Finally, in terms of efficacy the undescended IUCD strings were observed in 7%, expulsion incidence (6%), discontinuation requested by (5%) and none of the case ended up in pregnancy. Conclusion: Post partum IUCD insertion immediately following delivery is an effective, safe, and acceptable long-term reversible method available for postpartum contraception.

scholarly journals Comparative study of post-partum intra uterine contraceptive device insertion and interval intra uterine contraceptive device insertion in a tertiary care hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2760
Author(s):  
Manimegalai R. ◽  
Suganthi R.
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Family Health ◽  
Common Reason ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Medical College

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.

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.

scholarly journals A novel approach to meet the unmet need for family planning

2018 ◽  
Vol 8 (1) ◽  
pp. 169
Author(s):  
Subrata Samanta ◽  
Sujoy Dutta ◽  
Sudipta Samanta ◽  
Agrima Mullick
Keyword(s):  
Family Planning ◽  
Post Partum ◽  
Tertiary Care ◽  
Unmet Need ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Expulsion Rate ◽  
Satisfaction Rate ◽  
Novel Approach

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.

scholarly journals A prospective study to evaluate safety, efficacy and expulsion rate of post-partum insertion of intrauterine contraceptive device in a tertiary care centre

2017 ◽  
Vol 6 (3) ◽  
pp. 814
Author(s):  
Sudha R. ◽  
Nikita Singh
Keyword(s):  
Developing Countries ◽  
Prospective Study ◽  
Retention Rate ◽  
Post Partum ◽  
Public Awareness ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Contraceptive Device ◽  
Widespread Application

Background: The concept of contraception is not new, but its widespread application definitely is. Contraceptive availability is paramount for the health of women of reproductive age group. Among the variety of options available, female sterilization and IUCD are the most popular in developing countries. This study was conducted to assess the safety, incidence of complications, expulsion rates and willingness to continue at a 6 weeks’ follow-up period; after insertion of Cu T 380 A within ten minutes of placental expulsion both in vaginal and C-section deliveries.Methods: Prospective study in the Department of Obstetrics and Gynaecology, Cheluvamba Hospital from a period of 1st January 2016 to 31st June 2016. All consenting antenatal cases including referrals, who fulfil all the inclusion criteria were included in the study. Expulsion rates at 6 weeks’ follow-up were measured.Results: Total women counselled were 462, accepted 50, declined 412, lost to follow up 3, followed up 47, expulsion 3, bleeding 11, string problems 5, removal 8, continuation 36.Conclusions: PPIUCD is demonstrably a safe and effective contraceptive with high retention rate in the hands of a skilled caregiver. Strategies to increase public awareness through media sources are the need of the hour. Training of healthcare providers, cash incentives to acceptor, motivator and provider would further promote its use in developing countries like India.

scholarly journals Composition of Vaginal microbiota and their antibiotic susceptibility in symptomatic women

2017 ◽  
Vol 6 (2) ◽  
pp. 427
Author(s):  
Ushadevi Gopalan ◽  
Sathiyakala Rajendiran ◽  
Karthika Jayakumar ◽  
Ranganathan Karnaboopathy
Keyword(s):  
Candida Species ◽  
Antibiotic Susceptibility ◽  
Pathogenic Bacteria ◽  
Vaginal Discharge ◽  
Tertiary Care ◽  
Vaginal Swab ◽  
Reproductive Age ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
Age Group

Background: Bacterial vaginosis is the most prevalent lower genital tract infection in women of reproductive age. The aim of this study was to identify the causative organism in patients with vaginal discharge and to study the sensitivity of the organism to antibiotics.Methods: This was a hospital based prospective study in Department of Obstetrics and Gynecology in a tertiary care hospital over a period of two years. 2062 women with complaints of vaginal discharge were subjected to a high vaginal swab and the sample was cultured, the organisms were identified and antibiotic susceptibility was tested.Results: There was no growth found in 40.7% of patients. E. coli was found to be the most common organism isolated followed by Klebsiella pneumonia and Klebsiella oxytoca. Candida species was isolated in 1.4 % of women. An increased frequency of vaginal infection was found in the age group 26-35 years, followed by age group 36-45 years. 73.2% of the organisms were sensitive to Imipenam, 70.4 % to Amikacin and 65.7% to Gentamycin. There were 10 MRSA strains isolated all of which were sensitive to Vancomycin, Amikacin and Gentamycin.Conclusions: Our study provides information about the different microorganisms present in women with vaginal discharge. Since pathogenic bacteria were more common than Candida species it is recommended to offer treatment to patients after taking a high vaginal swab. Appropriate antibiotics based on culture and sensitivity has to be given along with antifungal agents.

scholarly journals Trends of Gestational Trophoblastic Disease at a Tertiary Care Hospital

2018 ◽  
Vol 12 (1) ◽  
pp. 26-31
Author(s):  
Beemba Shakya ◽  
Gehanath Baral
Keyword(s):  
High Risk ◽  
Vaginal Bleeding ◽  
Actinomycin D ◽  
Tertiary Care ◽  
Low Risk ◽  
Risk Scores ◽  
Care Hospital ◽  
Common Presentation ◽  
Invasive Mole

Aims: The objective of this study was to determine the clinical presentation of GTD and response of GTN to single and multiple agent chemotherapy on the basis of WHO Prognostic risk scoring system.Methods: This was a cross-sectional retrospective study undertaken at Paropakar Maternity and Women’s Hospital. The medical records of 102 GTD cases were reviewed from January 25, 2015 to January 24, 2016. Data pertaining patient characteristics, histopathology types of GTD, management, prognostic risk scores, chemotherapy, follow up and remissions were retrieved and were analyzed using SPSS version 16.0.Results: Among 102 GTD cases, the most common presentation was vaginal bleeding 69(67.6%) followed by ultrasound diagnosed cases 30(29.4%). Primary management of all cases were suction evacuation, 68 completed and 12 are under follow-up. GTN was diagnosed in 14/90 (15.5%) of complete mole and 5/90 (5.5%) of partial mole. Twenty-two cases received chemotherapy for persistent gestational trophoblastic tumour(19) and invasive mole(3). Twenty cases were low risk score group and two cases under high risk group. Out of 20 low risk cases that received MTX-FA, 13/20 (65%) achieved remission. Due to low response of MTX-FA, five of them were converted to Actinomycin-D and achieved remission (100%). Two high risk cases received EMA-CO regimen and achieved 100% remission. Two low risk GTN, complete and invasive mole (underwent hysterectomy) are undergoing MTX-FA chemotherapy.Conclusions: The most common presentation of GTD was vaginal bleeding. Low risk GTN achieved 65% remission with Methotrexate-Folinic acid, ultimately achieved 100% remission with Actinomycin-D. High risk GTN achieved 100% remission with EMA-CO regimen.

PREVALENCE OF MICROBIOTA ASSOCIATED TO VAGINAL DISCHARGE AMONG REPRODUCTIVE AGE GROUP BASED ON SOCIOECONOMIC STATUS AND DEMOGRAPHIC BACKGROUND

2021 ◽  
pp. 49-50
Author(s):  
Neha Yadav ◽  
Sonu Panwar
Keyword(s):  
Socioeconomic Status ◽  
Bacterial Vaginosis ◽  
Vaginal Discharge ◽  
Demographic History ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Care Hospital ◽  
Women Of Reproductive Age ◽  
Biochemical Tests ◽  
Gram Staining

In women of reproductive age, vaginal discharge is one of the most frequent signs. Vaginal discharge may be physiological or pathological; thus, this study was conducted to ascertain the microbial diversity of vaginal discharge cases in relation to socioeconomic status and demographic history among women of reproductive age attending a tertiary care hospital. To diagnose the organism, simple wet laboratory preparation, 10% KOH, Gram staining, and pH paper were used, while to classify and categorise the pathogens, various differential agar media such as CHROM agar, Blood agar, and Sabouraud Dextrose agar were used, followed by some biochemical tests and the use of the Nugent Score. The majority of the patients were between the ages of 22 and 28. The patients were all from the lower middle class 41. (37.61 percent ). Microbial diagnosis revealed that 45 percent of patients had Bacterial Vaginosis, 41 percent had Candidiasis, 5% had Trichomoniasis, and 9% had both Bacterial Vaginosis and Candidiasis..

scholarly journals Progesterone only pills: an effective contraceptive option for lactating women

2017 ◽  
Vol 6 (10) ◽  
pp. 4399
Author(s):  
Michelle Fonseca ◽  
Prasad Yeshwant Deshmukh ◽  
Deepali Kharat
Keyword(s):  
Low Dose ◽  
Tertiary Care Hospital ◽  
Post Partum ◽  
Tertiary Care ◽  
Lactation Period ◽  
Care Hospital ◽  
Lactating Women ◽  
Effective Contraceptive ◽  
Spacing Method

Background: Progesteone only pills (POP) are the most suitable for breastfeeding women as they have no effect on quality and quantity of breast milk in lactating women or on infant growth as well.Methods: A study was conducted on post partum lactating women over a period of 6 months at a tertiary care hospital in Mumbai. Post partum women were called for follow up in the post natal OPD and were counseled about temporary and permanent spacing methods.Results: Progesterone only pills are an acceptable and convenient means of temporary contraception / spacing during lactation period in motivated patients who do not want IUCDs or Injectables or are undecided about permanent methods of family planning.Conclusions: Low Dose progesterone only minipill is both effective and acceptable to breast feeding women. It may be used as a temporary spacing method in women who do not prefer an IUD but who are motivated to be complaint with its use.

ACCEPTANCE, COMPLICATION, EXPULSION AND FAILURE RATE OF POSTPARTUM IUCD IN A TERTIARY CARE HOSPITAL

2021 ◽  
pp. 44-46
Author(s):  
Sumit Ranjan Pramanick ◽  
Saumen Mandal ◽  
Bharat Chandra Mandi ◽  
Debarshi Jana
Keyword(s):  
Family Planning ◽  
Population Policy ◽  
Post Partum ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Contraceptive Device ◽  
Care Hospital ◽  
Expulsion Rate ◽  
Study Results ◽  
The World

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.

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