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Background: To study the knowledge, current practices of family planning methods and acceptance post motivation.Methods: Cross-sectional study conducted at family planning OPD of AIIMS, New Delhi, India. A total of 1516 couples who came for MTP at any gestation couple were enquired about knowledge, currently used contraceptive method and reason for abortion. Couple was counseled and allowed to choose contraceptive method using cafeteria approach. Mean values of continuous data were tested using t-test/ANOVA. Categorial data were compared using chi-square/ Fischers exact test.Results: Mean±SD age of the women was 28.89±5.21 years with 9.98±4.56 weeks POG. Around 81% of women had one or more living children with 62.67% women with at least one abortion previously. Majority used male condoms (42.10%) followed by natural method (21.01%), Cu-T (3.80%), OCPs (1.65%), injectable (0.30%), I-pill (0.24%). Awareness was maximum for male condoms, Cu-T, OCPs, female sterilization (100%) and least for female condoms (20%) and LNG-IUS (8.46%). Contraceptive failure (68.90%), congenital abnormality in the fetus (22.40%), maternal disease (5.90%), rape (1.60%), completed family (0.80%) and not using any method (0.30%) were the reasons of abortion. Majority of abortions were in first trimester (70%). Post-motivation around 69.30% of the couples accepted some form of contraception. Female sterilization (32.50%) method accepted by the couples as compares to temporary methods (36.70%) such as Cu-T, OCPs, Injectables etc.Conclusions: Despite of awareness the family planning programme is unsuccessful largely due to inappropriate attitude. Behavioral modification and communication goes a long way to slove the problem.
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Introduction Mitral stenosis due to rheumatic heart disease is a common problem in India causing significant morbidity and mortality. We have compared the maternal and fetal outcome of women with severe mitral stenosis undergoing percutaneous balloon mitral valvotomy before or during pregnancy. Methods A total of 24 women of severe rheumatic mitral stenosis who underwent balloon mitral valvotomy before pregnancy (14 women, group 1) or during pregnancy (10 women, group 2) were included in the retrospective descriptive analysis. Results The mean age was 25.5 ± 3.6 yrs in group 1 and 25.7 ± 3.5 yrs in group 2. There was no difference in characteristics –primigravidas, time since diagnosis from pregnancy, NYHA (New York Heart Association) class and associated medical problems in the two groups. There was significant difference in cardiac events during pregnancy in the two groups. New York Heart Association class deterioration was observed in only 3(21.4% women in group 1) as compared to all (10; 100% women) in group 2(p < 0.001). The incidence of arrhythmias and atrial fibrillation was not different in two groups. Obstetric events were similar in the two groups. Mode of delivery and caesarean section rate was also similar in the two groups. There was no significant difference in mean birth weights (2399.75 ± 601.8 gm vs. 2641.70 ± 580.6 gm),rate of fetal growth restriction, still birth and congenital malformation rates in the two groups. Conclusion Percutaneous mitral valvotomy for patients with severe mitral stenosis can be safely performed during pregnancy and has equivalent maternal and fetal outcomes as that performed before pregnancy.
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Objectives To study pregnancy outcomes in operated vs non-operated cases of congenital heart disease cases during pregnancy. Materials and methods A total of 55 patients of congenital heart disease who delivered in the authors unit in last 10 years were taken in this retrospective study. These were divided into two groups Group 1:29 (52.7%) patient who had no cardiac surgery and Group 2: 26(47.2%) who had cardiac surgery to correct their cardiac defect before pregnancy. All patients were evaluated for cardiac complications and outcome during pregnancy. Obstetric complications, mode of delivery and fetal outcome was compared in the two groups using statistical analysis. Result The commonest lesion was atrial septal defect (ASD) seen in 22(40%) patients followed by ventricular septal defect (VSD) in 16(29%) .Congenital valvular disease 8(14.5%) and patent ductus arteriosus in 4(7.2%) cases. The mean age was 25.9 ± 3.15 years in Group 1 and 26.3 ± 4.53 years in Group 2. The baseline characteristics were similar in the two groups. There was no difference in cardiac complications, NYHA deterioration and need of cardiac drugs in the two groups. Obstetric complications and mode of delivery were also similar in the two groups.Mean birth weight was 2516.65 ± 514.04 gm in Group 1 and 2683.00 ± 366.00 gm in Group 2 and was similar. APGAR < 8, stillbirth rate and other neonatal complications were also similar in two groups. Conclusion The maternal and fetal outcome was excellent in patients with congenital heart disease and was similar in unoperated and operated cases.