ABSTRACT
India has a high rate of unintended pregnancies and abortions contribute to 8% of maternal mortality. The addition of injection depot medroxyprogesterone (DMPA) to the basket of contraceptives has allowed women to use a long-term contraceptive which does not require any user action to maintain efficacy and whose effect is easily reversible. Injectable progestins are now estimated to be used by 6% women globally.
ABSTRACT
Background: Population explosion is a major issue especially in our country with the second largest population in world next only to china starting the use of contraception in postpartum period is an effective method of increasing the gap between two pregnancies and hence reducing the family size. Objective was to study the efficacy of DMPA injection in postpartum period for contraception.Methods: The study was a prospective study conducted on 100 patients during June 2018 to May 2019 in the department of obstetrics and gynaecology, S. P. Medical College Associate A. G. H., Bikaner, Rajasthan, India.Results: In present study mild irregular bleeding was present in 21, 35 and 38 cases at initial visit, at 3 months and at 6 months follow up respectively. Moderate irregular bleeding was present in 8 cases at initial visit, 27 cases at 3 months and 18 cases at 6 months follow up while 37 and 43 cases had severe irregular bleeding at 3 and 6 months follow up respectively. At baseline, 89 and 10 and 1 cases had their blood sugar <100, 100-120 and >120 respectively, at 3 months follow-up, 94, 6 and 0 cases had their blood sugar level <100, 100-120 and >120 respectively while at 6 months follow-up 97, 3 and 1 cases had their blood sugar level <100, 100-200 and >200 respectively.Conclusions: Injection DMPA use in postpartum period is safe, effective and reversible method with no deleterious metabolic effects and do not need special training to administer to it, so it is a good option of contraception for women who are lactating.
ABSTRACT
Background: The advanced contraceptive devices available nowadays have minimal side effects and utmost efficacy. The use of safe and effective contraception is the need of the hour in India. Inj. Depot medroxy progesterone (DMPA) has been found to provide effective, long acting and reversible contraception in lactating mother and post-abortal patients. Objective of this study was to describe the profile of women utilizing inj. DMPA as a contraceptive, to determine its compliance and to assess the factors affecting discontinuation of inj. DMPA (Anthara) at the government tertiary care institute in Mandya.Methods: The present study was a record-based study of 18 months (January 2018 to June 2019). The records of 266 women who utilized inj. DMPA as contraception in our institution was analysed.Results: It was observed that out of 266 women 48.5% were from age group of 21-25 years and 64.3% were primipara. Most of the women who initiated inj. DMPA (Anthara) were in the lactational period (56.0%). Most common side effect was irregular bleeding (54.8%). Discontinuation rate was 55.6% after first injection and 16.9% after second injection and gradually reduced with subsequent injections. The most common reason for discontinuation was irregular spotting per vagina (53.9%).Conclusions: Inj. DMPA is a safe, effective, long acting contraceptive taken once in three months. Many women in early reproductive age and lactational period are using inj. DMPA (Anthara) for contraception because of its convenience of dosing and is easily made available at government health care centres free of cost and has no effect on lactation. Discontinuation rate can be reduced by proper counselling.