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Background:Unplanned pregnancy may be the reason of many neonatal and maternal adverse effects. The objective is to study various factors affecting IUCD (temporary contraceptive method) preference. Material And Methods:A record based study of data of 483 couples selecting IUCD, during the one year period was collected with permission from tertiary care hospital. Result:The most common group preferring IUCD was 21-30 years (mean age-females-26 years and males-30 years).Majority having 2 children opted for IUCD while only 1 couple opted for IUCD without any child. Out of the total, 42% opted PPIUCD, 42% interval IUCD and 16% PAIUCD. Among lower age and up to primary educated groups, majority opted for PPIUCD. Among higher age and educated groups, majority opted for interval IUCD. PAIUCD proportion was higher in less educated females. Majority ofMuslims preferred PPIUCD while Hindus, interval IUCD. The association of type of IUCD with age, number of children and religion was found significant while with education, it was in-significant. Conclusion:The use and type of IUCD preferred depends on various factors such as age of male and female, number of children and religion of couples.
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Background:Unplanned pregnancy may be the reason of many neonatal and maternal adverse effects. The objective is to study various factors affecting IUCD (temporary contraceptive method) preference. Material And Methods:A record based study of data of 483 couples selecting IUCD, during the one year period was collected with permission from tertiary care hospital. Result:The most common group preferring IUCD was 21-30 years (mean age-females-26 years and males-30 years).Majority having 2 children opted for IUCD while only 1 couple opted for IUCD without any child. Out of the total, 42% opted PPIUCD, 42% interval IUCD and 16% PAIUCD. Among lower age and up to primary educated groups, majority opted for PPIUCD. Among higher age and educated groups, majority opted for interval IUCD. PAIUCD proportion was higher in less educated females. Majority ofMuslims preferred PPIUCD while Hindus, interval IUCD. The association of type of IUCD with age, number of children and religion was found significant while with education, it was in-significant. Conclusion:The use and type of IUCD preferred depends on various factors such as age of male and female, number of children and religion of couples
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Background: Health and family welfare of Indian Ministry, emphasis on postpartum IUCD insertion. Here we conducted a clinical study comparing intra-caesarean and interval CuT-380A insertion in caesarean deliveries.Methods: A systematic study with 150 patients in each group, recruited clients alternately. Group A Intra-Caesarean Cu-T insertion and Group B Interval Cu-T insertion in caesarean deliveries. Groups were followed up at 6th week and 6th month post insertion with a set of parameters. Missed strings, expulsion and infection rates were the primary outcome measures.Results: Infection rate is higher in Group A (2.3%) at 6th week, and at 6th month infection rate is higher in Group B (1.8%). Missed strings are higher in intra-caesarean than in interval insertion method both at 6th week and 6th month follow up p=0.000, hence significant. Expulsion rate is higher in Group A (2.5%) at 6th week, and at 6th month expulsion rate is higher in Group B (1.9%). There are no complications such as uterine perforation or contraceptive failures in both the groups during the study period. By analysis, there are no significant differences in infection and expulsion rates between the groups. For missed strings there is significant difference between the groups with more missed strings in intra-caesarean insertion method.Conclusions: To conclude, intra-caesarean method is equally effective as interval IUCD insertion method without added complications in caesarean deliveries, with advantage of high motivation, good compliance, safety and ease for the provider to deliver services.
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Background: Maternal cardiac disease is a major cause of non-obstetric maternal morbidity and mortality. The care of pregnant women with cardiac disease requires a multidisciplinary approach, involving obstetricians, cardiologists and anesthesiologist.Methods: A prospective analytical study of maternal heart disease and its fetomaternal outcome is carried out in the department of obstetrics and gynecology at tertiary hospital and teaching institute. The study was carried out on 50 cases belonging to age group 18-50 years with various cardiac diseases during their pregnancy and peripartum period.Results: In this study, 78% of the cases were registered with our hospital. The present study shows about 32% of the women having cardiac disease were in the age group of 20-25 years. 34% belonged to NYHA class II and had a relatively uneventful peripartum period. Among all forms of heart disease, RHD was common constituting 26% of cases. Most common condition associated with cardiac disease in pregnancy was preeclampsia (36%) in our study, with anemia being other one (10%). The common complications were congestive cardiac failure (12%) and pulmonary edema (8%). Combination of diuretics and beta blockers was used most commonly (22%). 56% of women delivered with caesarean section. 42 patients delivered after age of viability with 29 (69%) term deliveries and 13 (30%) preterm deliveries with 8 requiring NICU care.Conclusions: Valvular heart disease of rheumatic origin is the most common cardiac disease associated with pregnancy.The availability of adequate systems of early diagnosis of cardiac lesion, reference to tertiary care center & close monitoring of patient and delivery with multidisciplinary approach include specialized cardiologic care, high risk obstetric support and neonatology expertise that can minimize the serious consequences and helps to improve fetomaternal outcome. Pre-conceptional counseling and surgical correction of certain conditions improves maternal as well as fetal outcome. Awareness needs to be created about heart diseases during pregnancy and the importance of regular antenatal check-ups.
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Background: Family planning is important not only for population stabilization, but it has been increasingly recognized as central tool to improve maternal and neonatal health. Aim of current study was to compare interval and post partum intrauterine contraceptive device (IUCD) insertion in terms of effectiveness and safety.Methods: This was a prospective observational cohort study, done in the department of Obstetrics and Gynecology, GMERS Medical College, Sola, Ahmedabad, from August 2015 to April 2017 was taken for evaluation. 80 women in each group who were inserted IUCD after delivery and in the interval period were studied. Outcome was measured by expulsion rate, continuation rate, and incidence of dysfunctional uterine bleeding (DUB), Pelvic inflammatory disease (PID), failure rate and effect on puerperium.Results: Expulsion rate in PPIUCD group was 8.75% while in interval IUCD group it was 1.25%. Continuation rate following Postpartum intrauterine contraceptive device (PPIUCD) and interval IUCD insertion was 86.25% and 95% respectively. Incidence of bleeding per vaginum (menorrhagia) was 7.5% in PPIUCD group while 8.75% in interval IUCD group. There was one case 1.25% of PID in interval IUCD group while no case in PPIUCD was noted. Failure rate was nil in both the group. There was no effect on puerperium following PPIUCD insertion group during present study.Conclusions: PPIUCD is an effective and safe spacing method of contraception as compared to interval IUCD insertion. There is no statistically significant change in incidence of expulsion rate, continuation rate and other complications in both the group.
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Background: Intrauterine contraceptive devices are one of the most efficient, cost effective long acting reversible contraceptives. But the worrying clinical symptoms, misconceptions and higher rates of genital tract infection have become a hurdle in its acceptance as the first choice of contraception. The objective of this study was to study the common reasons for removal of IUCD.Methods: An observational study was done involving 430 women who reported to the OBG Outpatient of the hospitals attached to Bangalore Medical College, over a period of 2 years, for IUCD removal. Socio-demographic details, clinical symptoms compelling IUCD removal were elicited. The removed IUCD was subjected to culture and sensitivity. Initial descriptive analysis was used and statistical tests of significance like chi-square were used to know the relation between genital infections and IUCD. P value <0.05 was considered significant.Results: Of the 430 women, 46.9% were between 21-25 years of age, 49.3% were primipara, and 71% used IUCD for 1-3 years. Most common reason for removal in the first 2 years was heavy menstrual bleed followed by pain abdomen. 15.3% culture reports showed growth of bacteria, with maximum cultures positive in <5 years of usage, the association was statistically significant.Conclusions: Present study shows a lower risk of bacterial infections among IUCD users. Hence, effective counseling regarding the safety of IUCD over other spacing methods is essential to increase its acceptance.
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Background: Despite the availability of modern and scientific measures, unacceptably high numbers of maternal deaths still occur in developing countries. Spacing methods of family planning may avoid maternal and infant deaths. The Government of India launched postpartum IUCD (PPIUCD) services in the year 2000; although acceptance of Postpartum IUCD is a real concern.Methods: The retrospective study was conducted in rural government hospital in Maharashtra during 2016 - 2017. We analyzed sociodemographic variables and acceptance of Postpartum IUCD among postpartum women. The sample size was 595 (N=595). The sociodemographic factors studied included age, type of delivery, sex of newborn, socioeconomic status, educational status, etc.Results: The total postpartum women included in the study was 595, out of which, 202 (34%) accepted for postpartum IUCD whereas 393 (66%) rejected for the same. The most common age group was 20-25 years (65%), followed by age group 25-30 years (30%). Primipara was the comment group (45%) and normal vaginal delivery was common (95%). The educational status of both, the postpartum women and their husband, showed statistically significant association with acceptance of postpartum IUCD (p<0.05).Conclusions: The acceptance Postpartum IUCD was low (34%). The women’s and their husband’s educational status is an important factor in acceptance of Postpartum IUCD (p<0.05). Due attention should be given to enhancing educational level of women, also effective counselling both for pregnant woman and her husband during ANC is required.
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Background: Maternal mortality is an important target of health care policies, especially in India. While numerical indicators of maternal health improve, this can only be sustained with change in the knowledge, attitudes, and practices of women. Gender empowerment is a neglected aspect of health care policy, and there is a need to assess the perceptions of Indian women, the true torch-bearers of change.Methods: This was a hospital based cross sectional quasi-quantitative study in a sub-district hospital in the town of Ballabgarh, Haryana, India. Married women attending the outpatient clinic, antenatal clinic, labor ward, and primary health centres in the age group of 20 to 40 years were interviewed using a semi-structured questionnaire with both closed and open-ended questions. Health concerns were concurrently addressed.Results: Author interviewed 956 women. No form of modern contraception had ever been used by 58.36% of the women. Intra-uterine contraceptive devices were discontinued by 76.12% of the women who had used them. Emergency contraception was a concept known to 49.89% of the women, but fraught with misconceptions. Induced abortions was being used as a form of family planning, with nearly 90% of the women having taken over-the-counter abortifacients. Women were receptive to contraception, and many expressed an interest in long acting contraceptives other than IUCDs.Conclusions: This study provides insight into the thinking of Indian women regarding family planning. This may help guide family planning policies.
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Background: Vulvovaginal candidiasis (VVC) is a common infection among reproductive age group females. The objective of present study is to determine the prevalence of vulvovaginal candidiasis, its distribution and association of risk factors among reproductive age group females, attending the outpatient department of obstetrics and gynaecology of our Prime Medical Centre, Sharjah attached with Prime Hospital, Dubai, United Arab Emirates (UAE).Methods: It was cross-sectional descriptive study over a period of six months. Patients who came to our outpatient department with complains of vaginal discharge and itching in reproductive age group were included in this study. Patients characteristics i.e. age, parity, risk factors like diabetes, pregnancy, use of oral contraceptive pills (OCPills) and intrauterine contraceptive device (IUCD) were noted. High vaginal swabs (HVS) were collected and sent for culture. Candida positive cases were noted, and results were analyzed.Results: A total of 224 high vaginal swabs were collected. Prevalence of vulvovaginal candidiasis was found to be 31.6%. It was found more in 26-30 years age group and multiparous women. Previous history of candidiasis and diabetes were the commonest risk factors. Frequency of C. albicans was more (76.05%) than non-albicans candida (23.94%).Conclusions: Present study concluded that vulvovaginal candidiasis is more prevalent in reproductive age group females, therefore a routine high vaginal swab culture must be performed in every woman presenting with vaginal discharge and itching for correct diagnosis. Women should be educated on clinical symptoms.
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Background: The objective of this study was to compare the efficacy and safety of PPIUCD and interval IUCD.Methods: This was a prospective observational study conducted on women attending the OPD and indoor services of S.N. Medical college, Agra. 800 women willing for PPIUCD insertion were included in the study after informed consent excluding chorioamnionitis, PROM>18 hours, unresolved PPH and puerperal sepsis. Another 200 willing women were inserted interval IUCD according to MEC criteria of WHO. All were followed up for 1 year.Results: It was found that rate of expulsion was more in PPIUCD group compared to interval IUCD group (6%vs 1.5% p value <.05),rate of removal was almost similar in both groups (11.5%inPPIUCD and 14%in interval IUCD group), cause of removal was mainly social in PPIUCD group while bleeding was more in interval IUCD group compared to PPIUCD (85.7%vs26%).Conclusions: Postpartum insertion of IUCD is a safe effective, feasible and reversible method of contraception.
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Background:Post partum period is ideal time for family planning counselling. Accessibility to health care facility is more during this period in our country. IUCD to prevent pregnancy is a highly effective, safe, long acting, coitus independent & reversible method of contraception with very low side effects.Objectives:This study was conducted to evaluate the awareness, acceptance, safety, efficacy, complications and expulsion rate of Post–partum Intrauterine Contraceptive Device (PP–IUCD) insertion among pregnant women in a tertiary care centre.Material and Methods: This was a prospective study was carried out in the department of Obstetrics and Gynaecology, Career Institute of Medical Sciences from November 2014 to October 2016 (ie.2years). Women delivering in the hospital and fulfilling inclusion criteria were included in the study after obtaining informed consent. The study protocol was approved by the ethics committee of the medical college. Results:Out of 1820 women, only 108 (5.9%) were aware about PP–IUCD and they received information from the IEC material displayed in the antenatal clinic. Out of these 108 women, 70 women (64.8%) agreed with PP–IUCD insertion. Out of 1712 unaware women, 930 (54.3%) agreed with PP–IUCD. Agreement with PP–IUCD insertion was higher in women who were aware about the PP–IUCD. Overall acceptability was found in 1000 (55%) patients. Out of the 1000 (55%) women who accepted the PP–IUCD insertion, only 573 (31.4%) women underwent PP–IUCD insertion. After PPIUCD insertion, 67.2% of women had an uneventful course and 32.8% women had complications. Not a single woman suffered from perforation, or any other life–threatening complication. Conclusion: The acceptance of PP–IUCD was high in present study and it is comparably more than other studies done globally. Awareness of PP–IUCD among these women was very poor despite high acceptance.The PP–IUCD was also demonstrably safe, having no reported incidence of perforation with low rates of expulsion, pelvic infection, and few lost strings.
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Introduction: The present study was done to determine acceptability of intra-operative placement of IUCD among women undergoing caesarean section and to observe its efficacy. Materials & Methods: A descriptive cohort study was conducted with 100 women undergoing caesarean section. Routine hematological, urine investigation and USG was done for all cases. The IUCD was introduced through the uterine incision during caesarean section and placed at the rd nd th uterine fundus. The participants were asked to return for scheduled follow up visits at 3 Post-op day, 2 week & 6 week or earlier in case of any adverse event like pelvic pain, foul smelling vaginal discharge or excessive bleeding. Data was analyzed using SPSS ver 20.0. Results: Total 100 patients were counseled for IUCD out of which 40 patients accepted insertion of intracesarean PPIUCD. Majority of the patients (58%) who accepted intracesarean PPIUCD were in the age group of ≤20-25 years (p>0.05). A significant association was observed between acceptance of IUCD with education, employment and parity. Out of 40 females, 36 (90%) were fully satisfied after 6 weeks. It was observed none of the patients with Intracesarean IUCD conceived in 1 year follow up. Conclusion: Intra-operative placement of IUCD is an effective method of contraception with low expulsion rate and high continuation rate. Hence it is highly recommended as an effective method of postpartum contraception in developing countries
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Background: In India, 65% of women in the first year of post-partum period have an unmet need for family planning. Hence contraception needs to be practiced in this critical period. Aim: The present study was planned to evaluate the efficacy, safety, and compliance of intra Cesarean IUD insertions. Materials and methods: This was a prospective study for 3 years. Women recruited had CuT-380A insertion immediately after delivery of the placenta during Elective /Emergency Cesarean section. Women having unresolved post-partum hemorrhage (PPH), pre-labor rupture of membranes of (PROM) >18 hrs, fever >38 ˚C, congenital uterine malformation and fibroid uterus distorting the cavity were excluded from the study. The women were followed up with 3 visits at 4- 6 weeks, 3 months and 1 year. Results: Total women counseled were 4141, accepted no was 2850, declined no was 1291, consented but not inserted in 109 as criteria was not met. Lost to follow up 46, followed up 2850, complications (Expulsion 6, IUCD in situ with pregnancy 1, Bleeding 33, String problem 363, Removal 28, Continuation 2745). Conclusion: Immediate post –placental IUCD insertion provides highly effective contraception to the woman at the time of discharge itself. The government needs to develop strategies to increase public awareness of the PPIUCD through different media sources.
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Background: An effective contraception is the only way to stop this population explosion. There are too advantages and side effects associated with the IUCD, But most of side effects are effectively controlled by proper selection of clients and counseling process. Objective: To know the pattern of side effects and reason for removal among beneficiaries. Methods: A cross sectional study was conducted in 400 beneficiaries selected using systematic random sampling. Study sites included both urban and rural area. Data was entered and analyzed using MS excel sheet. Results: In this study maximum client 348 (87%) belonged to age group of 21 to 30 years. 47 (11.8%) clients were illiterate and 285 (71.3%) clients were unemployed/housewife. Most common side effect was pain with heavy bleeding in 30.6% clients, pain in 23.8% clients and pain with light spotting in 18.4% clients. Most common reasons for removal were pain with heavy bleeding in 42.6% clients while 10 (12.8%) clients removed due to husband’s insistence. Conclusions: After ICUD insertion 36.8% clients had side effect. Pain with heavy bleeding, pain with light spotting and only pain are the most common type of side effects. Removal of ICUD was 19.25%. Most common reason for removal was pain with heavy bleeding.
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Cases of extra uterine translocation of intrauterine contraceptive device (IUCD) to adjacent structures like peritoneal cavity, urinary bladder & sigmoid colon have been reported. Here is a case of translocation of IUCD into the caecum presenting as appendicitis. Appendicitis resulting from IUCD translocation is very rare. As per our knowledge only 19 cases have been reported earlier.
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Pelvic actinomycosis is an uncommon condition, often associated with the use of intrauterine contraceptive device (IUCD). Pelvic actinomycosis is rare accounting for 3% of all human actinomycotic infections. Ovarian actinomycosis is even rarer. Here, we present a 24-year-old woman using an IUCD for 3 1 / 2 years with right-sided adnexal mass, which was diagnosed postoperatively as tubo-ovarian actinomycosis. Many times, an appropriate management is overlooked or delayed due to its non-specific and variable clinical and radiological features. Sometimes, it can even mimic an advanced pelvic malignancy. Therefore, the gynecologist should consider the possibility of this infection to spare the patient from morbidity of radical surgical procedure.
Subject(s)
Actinomycosis/diagnosis , Actinomycosis/drug therapy , Actinomycosis/diagnostic imaging , Actinomycosis/surgery , Fallopian Tubes/pathology , Female , Histocytochemistry , Humans , Intrauterine Devices/adverse effects , Ovary/pathology , Ovary/diagnostic imaging , Pelvic Inflammatory Disease/diagnosis , Pelvic Inflammatory Disease/drug therapy , Pelvic Inflammatory Disease/diagnostic imagingABSTRACT
Ovarian pregnancy is a rare form of ecotpic pregnancy but most common of the non tubal ectopic pregnancy. One of the risk factor for ovarian pregnancy is the use of IUCD. We report one such uncommon case.
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1. 100 IUCD patient is hereby presented2. 32 of the 100 have objective manifestations3. 29 of the 32 have cervical lesions while 3 have vaginal pathologies4. 14 of the 32 had presented subjective manifestations, 8 of the 14 cases are infected and one of the 8 harbors 2 kinds of infections5. Two of the 100 mothers have a second degree perineal lacerations with a sequelae of uretrocystorectoceles6. Simple painting with 1:1000 Ziphiran and cautery plus treating specifically the infections had controlled and cleared the objective as well as the subjective clinical manifestations7. The knee-chest positon have help the urethrocystorectoceles victims. (Summary)