Treatment seeking behavior for urinary incontinence among north Indian women.

Background: Urinary incontinence is a common but neglected problem of women. Aims: To ascertain the treatment seeking behavior of north Indian women having urinary incontinence (UI). Setting: Two residential colonies of Chandigarh. DESIGN: Cross-sectional face-to-face interview based study. Materials and Methods: This study was conducted by a trained nurse during April 2005-July 2005 among women aged 18 years and above. Women with UI were identified in a screening survey. They were interviewed individually regarding their treatment seeking behavior and socio-demographic data. Statistical Analysis Used: Percentage, mean, standard deviation, chi-square test. Results: Of the 220 enlisted incontinent women 20% (44) women consulted some health agency. Only 8.6% (19) women had heard about pelvic floor muscle exercises. Seventy-two percent (158) cases had UI for more than one year. The most common reason quoted for not seeking treatment was, 'UI was considered as 'normal', 'did not take it seriously' and 'shyness.' Many (153;70%) women reported that UI affected their daily routine as well as social activities like shopping and visiting friends. Conclusion: Urinary incontinence seriously affected the quality of life of women. Still, consultation rate for UI was low in the north Indian women.

The impact of primary postpartum hemorrhage in "near-miss" morbidity and mortality in a tertiary care hospital in North India.

AIM: To assess risk factors, mortality and "near-miss" morbidity in early PPH. SETTING AND DESIGN: Retrospective analysis of 178 women with early PPH (within 24 h of delivery) over 4 consecutive years in a tertiary care hospital in North India. MATERIALS AND METHODS: All case sheets of patients identified by labor record registers as having early PPH were reviewed by the same person to identify the actual impact of condition. The data was analyzed by chi-square analysis. RESULT: Early PPH (loss of blood that caused significant alteration in maternal condition or blood loss 500 in vaginal deliveries or> 1000 cc in cesarean section) was recorded in 178; 90 delivered in hospital (Group-A) and 88 referred after delivery (Group-B) from various peripheral centers, i.e., maternity hospitals, nursing homes, district and community health centers. The maternal mortality ratio during this period was 1049/100,000 (139 deaths/13248 live births; direct maternal deaths = 94). Early PPH accounted for 11/94 direct maternal deaths (11.7%). Of these 11 deaths, 3 were in group A and 8 in group B. "Near-miss" morbidity was higher than mortality (Total 19/178; 5/90 in Group-A and 14/88 in Group-B). Delayed referral and lack of active 3rd stage management in Group-B were responsible for most of the adverse events. CONCLUSION: Both "near-miss" morbidity and mortality in early PPH reflect the level of obstetric care in the developing world. These need to be reduced by strengthening peripheral delivery facilities, active 3rd stage management and early referral.