Discontinuation rates among women using either the combined oral contraceptive pills or an intrauterine contraceptive device for contraception: a comparative study

To study the contraceptive practice of women using combined oral contraceptive pills and intrauterine contraceptive devices in 4 Jordanian military hospitals; [Prince Hashem Bin Al Hussein, Prince Ali Bin Al Hussein, Princess Haya Bent Al Hussein, and Queen Alia Hospitals] and to study the reasons for discontinuation of these methods among women less than 44 years of age. A retrospective analysis of the family planning medical files of 5800 clients who were current or past user of the contraceptive pills or intrauterine devices for contraception during the period between January 2007 and December 2009 was done. Fifty-eight percent [33671 5800] were current or past contraceptive pills users and 41% [2433/5800] were current or past intrauterine device users. Women included in the study were those who had discontinued using the pills or the devices for more than 6 months [n = 3200], which in turn were divided into two groups: Group A, oral contraceptive pills users [n=2050] and Group B, intrauterine devices users [n = 1.150]. We then analyzed according to age, parity, obstetric history, medical history, duration of contraception and reasons for discontinuation of these methods; the data were compared between the two groups.The use of contraceptive methods varies across age, but combined oral contraceptive pills was found to be the most commonly used method among the study population. Only 29% of group A discontinued the pills because of their desire to conceive compared to 23.6% of group B. Fifty-two percent of group A stopped the pills because of undesired side effects, compared to 65% among group B. Four-point-four percent of group A stopped the method due to medical indication compared to 3.2% in group B. Fourteen-point-six percent of group A stopped the pills for personal reasons or lack of availability of the drugs and 8.2% of group B had the device removed because it reached the expired date [being in uterus for 10 years]. However, this is not considered a reason for discontinuation. The main side effects of combined oral contraceptives were breast discomfort, mood changes, weight gain, headache, nausea and vomiting, whereas the commonest side effects related to intrauterine contraceptive device were menstrual bleeding disorders, recurrent vaginal infection, and pelvic pain. In spite of the safety and high efficacy of combined oral contraceptive pills and intrauterine devices as contraceptive methods more than half discontinued their use because of undesired side effects. This may be improved by careful patient selection and appropriate counseling

Does cord blood of thyroid stimulating hormone, T3 and T4 levels in infants differ in different modes of deliveries? A comparative study

To determine whether the levels of cord blood TSH, T3 and T4 are affected by different modes of delivery. This study was conducted out at Princess Haya Hospital over five months period [November 2004-March 2005]. Cord blood samples for TSH, T3 and T4 were taken immediately from neonates delivered by normal vaginal delivery and Caesarean Sections either as emergency or elective. One hundred and fifty cord blood samples were obtained from three groups [group 1-50 neonates delivered by normal vaginal delivery, group II- 50 neonates delivered by emergency Caesarean Section and group III- 50 neonates delivered by elective Caesarean Section]. All mothers of these neonates had no medical problems. Measurements of TSH, T3 and T4 levels were performed using IMX assay, which is a Micro particle Enzyme Immunoassay [MEIA] for TSH, T4 and T3. Simple descriptive statistics was used T-test was used to determine statistically difference between the study groups. The mean level of TSH in the cord blood samples taken from neonates delivered by normal vaginal delivery and emergency Caesarean Section was significantly lower than in elective Caesarean Section [p <0.005; 5.9 +/- 1.0 m I/ml, 5.8. +/- 1.3 m I/ml and 7.4 +/- 1.4m I/ml respectively]. Regarding T3 and T4, they were significantly higher in elective Caesarean Section than in normal vaginal delivery and in emergency Caesarean Section [p <0.05; T4 and T3 were 4.1 +/- 1.1 n g/dl, 6.9 +/- 1.5 pg/d L 2.1 +/- 1.3 n g/dl 5.5 +/- 15 pg/dl and 5.8 +/- 1.3 n g/dl and 5.9 +/- 2.5 pg/dl, respectively]. Our results showed that TSH, T3 and T4 are lower in normal vaginal delivery and emergency Caesarean Section than in elective Caesarean Section

Diagnostic evaluation of [pregnant] patient with acute abdominal pain. The role of imaging modalities

Assess the pregnant patient with other causes of pain not related to pregnancy presenting to emergency department, using different imaging modalities and to review the basic principles of radiation safety. During 18 months, 55 pregnant patients were referred randomly from emergency department for evaluation of abdominal pain prospectively enrolled into our study. Pregnant with pregnancy-related causes such as premature contractions and other related causes were excluded. US evaluation for all patients including a careful search for gall bladder, kidneys, pancreas and appendix related causes. Clinical, surgical, and/or imaging follow-up data were obtained in some patients. Out of 55 patients, 28[50.90%] were confirmed to have an eight with gall-bladder stones [14.54%] five with hydronephrosis related to pregnancy [9.08%], two of renal calculi [3.63%] one had bowel obstruction and pancreatitis [1.81%],seven with pyelonephritis[12.72%], and four with appendicitis [7.27%]. There is an increased incidence of acute abdomen during pregnancy though clinical pictures sometimes get blunted due to gravid uterus. Early diagnosis followed by surgical intervention if needed decrease morbidity for both mother and fetus, also enhances our knowledge of the principles of radiation safety