Cu-375 [multiload]; a safe cheap and effective method for reversible long-term contraception

To study the complications associated with the use of multi-load CU375 and reasons for discontinuing its use. Descriptive Study. From 10th January 2002 to 10th January 2004. Saleem Medical Complex Quetta. The study population included 100 women aged 22 ' 35 years requiring contraception in the form of multi-load CU 375. Patients and in some cases their husbands were counseled and selected according to a pre-set proforma. Out of 100 patients the mean age of the acceptors was 30 years and mean parity was 4. Insertion of the device was very easy, main complications were disturbed menstrual cycle, heavy menstrual bleeding experienced by 40%, inter-menstrual spotting by 8% and continuous vaginal bleeding by 3%, 2% of the patients had gestational ammenorrhea of 8 and12 weeks. Vaginal discharge was complained of by 10%. There were two expulsions and 7 removals, reasons for removal were metrorrhagia, menorrhagia, pain and spotting in most cases. There were no cases of perforation or ectopic pregnancy. It was concluded that multi-load CU 375 is an effective contraceptive device with menstrual irregularities and pelvic inflammatory disease being the main complications and principle causes for removal of IUCD

Obstructed labour; how can we help?

Obstructed Labour. To determine the frequency, risk factors, complications and maternal and foetal out come of obstructed labour. A tertiary care teaching Hospital. A retrospective study conducted at the department of Obstetric and Gynecology Unit II Sandeman Provincial Hospital Quetta. The Patients were selected on a random basis as they were admitted through emergency. 98 cases of obstructed labour were managed during the study period. All were non booked, illiterate majority belonged to poor socio-economical class, and came from far flung areas of Balochistan and Afghanistan. The most vulnerable group was grand multipara in third decade of life. The leading cause of obstruction was cephalopelvic disproportion. There was one rare case of Locked Twin and one very rare case of 6.0 x 4.5 cm vesical stone as cause of obstruction. 74 cases[74.5%] were managed by caesarean section. Out of 14 cases of Ruptured uterus 10[10.2%] were subjected to caesarean hysterectomy and the rest four were managed by repair with or without ligation in groups of two. Urinary fistula was found in 10 cases out of which two were ureteric fistulae and eight were vesico-vaginal. The over all perinatal mortality rate was 87%, with 100% in referred cases. The maternal mortality rate was < 1.0/ thousand in the referred cases. No maternal death occurred in cases who developed obstruction in the hospital