Met and unmet need of family planning and associated factors in a remote rural area of Sindh, Pakistan

To determine the met and unmet need of family planning among married women of Taluka Golarchi, District Badin, Sindh, Pakistan. Secondary objective was to assess the knowledge and practices of modern contraceptive methods and associated factors. It is a cross sectional community based survey done from 1[st] May to 31[st] May 2008 in Taluka Golarchi, District Badin, Sindh, Pakistan. A structured questionnaire was used to interview 300 eligible women of reproductive age. Stratified cluster sampling was done to collect information on met and unmet need of family planning, knowledge and practice of modern contraceptive methods and associated factors. Nearly two third of respondents were housewives and illiterate. Most of them 71% [213] were multiparous having more than four children. Current contraceptive practice was 42%, out of which 39% were using modern methods of contraception. Oral contraceptive pills were commonly used method. Unmet need of Family planning was 19%. Lady Health Workers were the prime source of knowledge and provision of family planning methods. Husbands' co-operation and approval is influential factor for modern contraceptive use. Fear of side effects is the main hurdle for non use of modern contraceptive methods. Modern methods of contraception are gaining popularity in rural Sindh. In addition to sustained lady health worker programme, involvement of males should be incorporated in future family planning initiatives

Severe acute maternal morbidity [SAMM] in postpartum period requiring tertiary hospital care

Postpartum period is the critically important part of obstetric care but most neglected period for majority of Pakistani women. Only life threatening complications compel them to seek for tertiary hospital care. We describe the nature of these obstetric morbidities in order to help policymakers in improving prevailing situation. To find out the frequency and causes of severe post-partum maternal morbidity requiring tertiary hospital care and to identify the demographic and obstetrical risk factors and adverse fetal outcome in women suffering from obstetric morbidities. This prospective cross-sectional study was carried out in the Department of Gynecology and Obstetrics, Liaquat University Hospital Hyderabad, between April 2008-July 2009. The subjects comprised of all those women who required admission and treatment for various obstetrical reasons during their postpartum period. Women admitted for non-obstetrical reasons were excluded. A structured proforma was used to collect data including demographics, clinical diagnosis, obstetrical history and feto-maternal outcome of index pregnancy, which was then entered and analyzed with SPSS version 11. The frequency of severe postpartum maternal morbidity requiring tertiary hospital care was 4% [125/3292 obstetrical admissions]. The majority of them were young, illiterate, multiparous and half of them were referred from rural areas. Nearly two third of the study population had antenatal visits from health care providers and delivered vaginally at hospital facility by skilled birth attendants. The most common conditions responsible for life threatening complications were postpartum hemorrhage [PPH] [50%], preeclampsia and eclampsia [30%] and puerperal pyrexia 14%. Anemia was associated problem in 100% of cases. Perinatal death rate was 27.2% [34] and maternal mortality rate was 4.8%. PPH, Preeclampsia, sepsis and anemia were important causes of maternal ill health in our population. Perinatal mortality was high

Asymptomatic bacteriuria in pregnancy

To determine the frequency and risk factors of asymptomatic bacteriuria during pregnancy. Descriptive study. In obstetric and gynecology outpatient department of Isra university hospital Hyderabad Sindh from 2 nd July to 10 th December 2007. Total 111 women were included in the study. Inclusion criteria were pregnant women with no clinical features suggestive of UTI. Symptomatic women, women with any medical or renal disease and those who had taken antibiotics in last 6 weeks were excluded from the study. Dipstick test was performed on MSU and urine was cultured incase of positive dipstick. Data was analyzed on SPSS version 11. Frequencies were runned and chi-square test was used as test of significance. A total of 111 women fulfilling the inclusion criteria were interviewed and tested for bateriuria. Out of them 10% [9%] had bacteriuria. Out of them 10% were below 20 years and 90% were between 20-30 years [p=0.17]. Regarding education 10% were literate and 90% were illiterate [p=<0.001]. Prevalence of bacteriuria was 100% in women who had past history of urinary tract infection [p=0.004]. 80% of women who were sexually active had bacteriuria while 20% had not [p=0.006]. No association of bacteriuria was found with anemia, age, parity and socioeconomic condition. Asymptomatic bacteriuria is a common infection during pregnancy, have strong association with education, past history of urinary tract infection and illiteracy