Post-sterilization regrets in Indian women.

BACKGROUND: Tubal ligation is the most common form of contraception in India. We conducted this study to assess the factors associated with post-sterilization regrets. AIMS: This study was designed to assess risk factors that are likely to cause regret following female sterilization in Indian women. SETTINGS AND DESIGN: Questionnaire-based study. MATERIALS AND METHODS: This was a questionnaire-based study to assess the level of satisfaction after tubal ligation in women attending family planning clinic at the hospital over a period of 1 year. Evaluation of data obtained through questionnaire from 236 women who had undergone tubal ligation was done. STATISTICAL ANALYSIS: Univariate analysis to determine crude odds ratio was carried out. Subsequently, multiple regression analysis was used to find the adjusted odds ratio (and 95% confidence intervals) for each variable. RESULTS: We found a strong co-relation between regrets and young age (less than 30 years), fewer number of children, few or no male children and lack of partner motivation prior to sterilization. Menstrual irregularities and dysmenorrhoea did not influence regret to a large extent. CONCLUSION: Fertility-related factors, namely, age at sterilization, family size, number of male offspring, timing of sterilization and non-involvement of partner in decision making played a greater role in post-sterilization regrets than menstrual factors (menstrual irregularities and dysmenorrhoea).

Comparison of Ofloxacin & Ornidazole with Probiotic versus Doxycycline & Metronidazole for the Outpatient Treatment of Pelvic Inflammatory Disease

The aim of the study was to compare the efficacy and cost effectiveness of ofloxacin, ornidazole, serratiopeptidase and Saccharomyces Boulardii combination with traditional doxycycline and metronidazole combination with serratiopeptidase in the outpatient management of pelvic inflammatory disease. A total of one hundred and ninety three women presenting with symptoms of pelvic inflammatory disease (PID) confirmed to be a case of PID on clinical examination were randomized to one of the two treatments. No investigations were performed to cut the cost and to avoid loss of follow up. A total of 98 women (Group I) were prescribed ofloxacin (400mg), ornidazole (500mg), Serratiopeptidase (10mg), Lactic acid bacillus 60 million spores and Saccharomyces Boulardii 2 million spores once a day for 10 days while a total of ninety five women (group II) were given a 10 day course of doxycycline (100 mg BD) with metronidazole (400mg TDS) along with 10mg of serratiopeptidase once daily. All women were seen after 2 weeks for relief of symptoms and possible side effects. The results were then analyzed. It was found that although the efficacy of both drug regimens was similar. The incidence of gastrointestinal side-effects mainly were less in group I. This was probably due to the addition of probiotic Saccharomyces Boulardii and lactic acid bacillus. The once daily administration led to better compliance in the first group.

Comparison of perinatal outcome of growth-restricted fetuses with normal and abnormal umbilical artery Doppler waveforms.

AIMS: To evaluate the role of umbilical artery Doppler in growth- restricted fetuses. MATERIALS AND METHODS: In a prospective observational study, 70 pregnant women with growth-restricted fetuses confirmed by ultrasound, were followed up with Doppler studies of the umbilical artery. The study group consisted of 35 women, where the Doppler waveform in the umbilical artery was compromised (either absent end diastolic flow [AEDF] or reversed end diastolic flow [REDF]). These were compared with an equal number of controls, where growth- restricted fetuses had normal doppler waveforms. Outcome measures were evaluated in both groups and analyzed. RESULTS: The periods of gestation at delivery were 27.2 +/- 3.5 weeks in group 1 and 37 +/- 3.3 weeks in-group II, respectively. Perinatal morbidity and mortality was significantly increased in the group with compromised umbilical artery blood group. Birth weight in group I was 742 +/- 126 grams and in group II was 1680 +/- 259 grams. This difference was statistically significant (P=0.0001). In comparison to AEDF, REDF fetuses had more morbidities. Perinatal mortality was also significantly increased in this group (P=0.001). CONCLUSION: Umbilical artery Doppler should be used in the management of growth-restricted fetuses. In those fetuses in normal Doppler, pregnancy can be prolonged. REDF is an indication for termination of pregnancy.

Pregnancy in a patient of Glanzmann's thrombasthenia.

Glanzmann's thrombasthenia is a congenitally acquired platelet disorder with an autosomal recessive mode of inheritance. Though, quantitatively normal, the aggregation ability of platelets is reduced in this condition. Pregnancy and delivery are rare in these patients and have been associated with a high risk of severe post-partum hemorrhage. We describe a primigravida, who was diagnosed to have Glanzmann's thrombasthenia during adolescence. She developed secondary post-partum hemorrhage after an elective caesarean section, which was successfully managed by single donor platelet transfusion.