Top PDF Study on acceptability and follow up of postpartum intrauterine contraceptive device in a tertiary care hospital

Study on acceptability and follow up of postpartum intrauterine contraceptive device in a tertiary care hospital

Study on acceptability and follow up of postpartum intrauterine contraceptive device in a tertiary care hospital

Contraceptive counselling was given to 932 eligible antenatal women admitted in labour ward from January to March . Women who accepted the PPIUCD after normal vaginal delivery and after caesarean section were inserted with the device after obtaining written informed consent. The acceptance rate of PPIUCD and the percentage of actual insertions were recorded . Among those inserted, 300 cases – 150 cases in post placental group and 150 cases in intra caesarean group were followed up at 6 weeks,3 months and 6 months to evaluate in terms of expulsion, removal and continuation.
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Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

Acceptance, safety and complications of postpartum intra uterine contraceptive device: a prospective study in tertiary care hospital

This study was conducted in Gynecology and Obstetrics department and family planning unit of Hindu Rao Hospital and North Delhi Medical College for a period of 18 months. All antenatal patients admitted in labor room for delivery in the hospital were counseled for post- partum IUCD 380A or 375 (Multiload). Women who were in the age group of 18-45 years with gestational age 36 - 41 weeks with Hb >9 gm% and no evidence of infection were considered for postpartum IUCD insertion. Patients with fever during labor or delivery or with ruptured membranes more than 24 hours before delivery, having active genital infection, needing manual removal of placenta or post-partum hemorrhage requiring additional oxytocics or women with known malformation of uterus were excluded from the study.
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Misplaced (''Missing'') Intrauterine Contraceptive Device Among Clients at a Rural Tertiary Hospital in South Western Nigeria

Misplaced (''Missing'') Intrauterine Contraceptive Device Among Clients at a Rural Tertiary Hospital in South Western Nigeria

Altogether, 13.6% of couples around the world have selected IUCDs for birth control. [2] In Nigeria, the level of acceptance ranges from 39.7%- 64% [3] with a failure rate of 1-2% each year has been reported worldwide. [2, 4] The IUCDs produce both morphological and biochemical changes in the reproductive tract by inducing inflammatory response in the endometrium, with associated increase in the levels of macrophages, and other inflammatory agents in the uterine and the tubal fluids. [5, 6]. The major risks reported in association with use of IUCDs include ectopic pregnancy, spontaneous abortion, uterine perforation and expulsion. [2, 5] Missing or misplaced IUCD is one of the setbacks associated with the use of the device. [7] Adewale et al reported an incidence of 1.4% of missing IUCD in Bida . [8] It should be noted that a missing IUCD string does not necessarily indicate perforation since it may occur when the device has been expelled unnoticed, rotation of the device within the uterine cavity, separation of the tail from the device, or rotation of string into cervical canal. [9] It has also been suggested that complete extrusion of IUCD through the myometrium may be assisted by spontaneous uterine contraction and hydrostatic negative pressure differences between the low intraperitoneal pressure and relatively higher intrauterine pressure. [10] The extruded IUCD may further migrate into the peritoneal cavity. Bowel and bladder perforations have been reported following uterine perforation due to misplaced IUCDs. [11] The risk factors for misplaced IUCD include the time of insertion, type, size and configuration of IUCD used as well as the skill and experience of inserter. [12] Proper insertion of an IUCD is important since it can affect effectiveness and acceptability of the method. [13] Expulsion rate are highest in the first year especially the first three months after insertion. [11] The expulsion is also increased after early postpartum period or following caesarean section but not after first trimester abortion. [14] The different diagnostic methods used in detecting missing IUCDs include pelvic examination with uterine sound, abdomino-pelvic ultrasound alone, abdomino- pelvic ultrasound complimented with hysterosalpingography (HSG), plain abdominal x-ray, HSG, laparoscopy, mini- laparotomy and laparotomy. [15] In some cases, there will be no associated symptoms and suspicion is made when the string cannot be identified. [7] This study was designed to document the prevalence, method of diagnosis, and management of misplaced IUCD at our centre.
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Prospective study on outcomes of postpartum intrauterine contraceptive device including safety, efficacy and expulsion at GMERS Medical College, Dharpur Patan, Gujarat, India

Prospective study on outcomes of postpartum intrauterine contraceptive device including safety, efficacy and expulsion at GMERS Medical College, Dharpur Patan, Gujarat, India

So, this study was planned to initiate contraception before hospital discharge after delivery. It is a potentially practical and cost-effective strategy to increase effective postpartum contraceptive use, given that the women are already within the health care system and motivation for contraception may be high. Studies published in nineties and early 2000 reported rates of expulsion of about 9- 13%. 7-9 However lower expulsion rates have been

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Post partum intrauterine contraceptive device: acceptability and safety

Post partum intrauterine contraceptive device: acceptability and safety

long term reversible method and may be an alternative to tubectomy. Its efficacy, compliance is high does not require daily self-administration and thus women can effectively avoid unintended pregnancies. Post-insertion symptoms are masked by the normal postpartum cramping and lochia. Postpartum insertion is convenient both for the women and the provider. Follow up can be scheduled along with immunization visits. A study on PPIUCD therefore, was done with the aim of future scope of the method, reasons for its acceptability, denial and associated complaints and complications.
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Prospective study on outcome of post partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

Prospective study on outcome of post partum intrauterine contraceptive device insertion at tertiary level rural health institute of Gujarat, India

A hospital based prospective study was conducted at one of the rural teaching tertiary care institutes of Gujarat, India between January to December 2017 duration. Purposive sampling method was used for selecting the study population. Total 150 females were included in the study by purposive sampling. Inclusion Criteria for the study were: Parturient between age 14 to 44 years, having hemoglobin level more than 8 gm/dl and who are willing to go for IUCD insertion were included in the study. Females having any kind of systemic illness and obstetric complications were excluded from the study. Counseling regarding insertion of IUCD was done in antenatal, intra partum and post partum period.
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A Study of 500 acceptors of intrauterine contraceptive device - Copper `T'

A Study of 500 acceptors of intrauterine contraceptive device - Copper `T'

device (IUD) insertion. METHODS : IUDs were inserted within 10 min after postplacental expulsion in term pregnancy both in vaginal and cesarean delivereies via a ring forceps. Of the 276 patients enrolled, 235 were included in the study. Recipients were scheduled for examination before hospital discharge and at 6 weeks, 6 months and 12 months after postplacental insertion. RESULTS : The percentages of women returning for a follow-up visit were 221 (94%), 210(89%) and 183 (78%) at 6 weeks, 6 months and 12 months, respectively. Among IUD acceptors, 74% of the cases had vaginal deliveries and 26% had cesaren deliveries. Continuation rates were relatively high, 87.6% and 76.3%, at 6 and 12 months, respectively, after postplacental insertion of IUD. In this study, the 1-year cumulative expulsion rate with Tcu 380A device was 12.3% which may be regarded as a standard expulsion rate for immediate postplacental insertion of similar models of IUDs. CONCLUSION : The evidence from this study suggests that immediate postplacental insertion of CuT 380 models is an effective, useful, safe, convenient and low-cost procedure for early postpartum contraception.
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Displaced intrauterine contraceptive device: a prospective study at tertiary level hospital of Uttarakhand, India

Displaced intrauterine contraceptive device: a prospective study at tertiary level hospital of Uttarakhand, India

Intrauterine contraceptive devices (IUCD) are safe effective reversible and reliable method of long term contraception. IUCD is the main stay of Contraception especially in developing countries, despite side effect and complication. Uterine perforation is rare but potentially serious complication with an incidence of less than one case per 1000 insertion. The large ongoing international prospective EURAS-IUD study (European Active Surveillance Study for Intrauterine Devices) revealed perforation rates of 0.68/1000 insertions for the LNG-IUS and 0.41/1000 insertions for Cu-IUCDs at 1 year of follow up (Heinmann 2015). 1 The risk factor for uterine
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Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

Postpartum intrauterine contraceptive device (PPIUCD) insertion: practices and aftermath at tertiary care centre

PPIUCD has distinct advantages as contraceptive during postpartum period as it is one-time application, provider has assurance that patient is not pregnant at the time of application and it can serve as both spacing and limiting in some cases. Main advantage of post-placental IUCD is that no additional hospital visit is required for insertion of IUCD and no pain on insertion when used post-placental or intra-caesearean. Also, initial cramping due to IUCD is shadowed with pain due to uterine contraction in puerperium. Few side effects which worried the patients were missing thread which occurred mostly after LSCS (due to coiling of thread) which needed USG for localization of Cu T and further reassurance. Another problem was women who came for early removal of PPIUCD had to undergo hysteroscopic removal because thread was coiled inside and was not visible to be removed on OPD basis. What authors found in present study was there were lots of misconception regarding IUCD like perforation, migration pain and bleeding problem. Rate of removal was high due to myths and family pressure.
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Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

Helping couples understand their risk of unplanned pregnancy and ensuring that high quality postpartum family planning services are available to them is the objective of an ideal contraceptive counselling. Linking maternal child health and family planning services is critical to achieve healthy spacing of pregnancy (HSP). This led to the revival of post-partum IUCD in 2010. Majority of participants accepted the method when they were given information during early labour (1280) compared to antenatal counselling (653). Those patients who were willing to accept during the antenatal period become reluctant later as they are more exposed to rumours and myths regarding copper T. Many studies have shown that when the husband is involved in counselling and decision making the acceptance and continuation rates were higher. A randomized prospective study conducted by Smith et al in antenatal clinics in China, Scotland and South Africa in which some women received information on contraception in antenatal care and some did not, found no difference in subsequent contraceptive use 10 . Mohammed et al observed that
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Enhancing contraceptive usage by immediate postpartum intra uterine contraceptive device insertion with evaluation of safety, acceptability and expulsion

Enhancing contraceptive usage by immediate postpartum intra uterine contraceptive device insertion with evaluation of safety, acceptability and expulsion

Major portion of women (58%) in present study had visited to hospital personally for follow up and minor portion (33%) who could not come for hospital visits were followed up on telephone. These minor portions of women expressed inability to travel for many reasons like staying in neighboring states, financial cost for travelling, no family member to accompany them with baby, etc. For similar reason most women (83%) could not review on exact 6 weeks follow up dates, though they followed up sometime after 6 weeks. A small proportion of women (16.4%) reviewed with 6 weeks for follow up for reasons like bleeding, pain abdomen, white discharge and in fear of long strings felt personally near perineum. The follow up rates were similar to that of Ranjana et al study. 8
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Evaluation of effect of pospartum intrauterine contraceptive device

Evaluation of effect of pospartum intrauterine contraceptive device

This prospective study was done in tertiary care center and teaching hospital in Maharashtra during Feb 2016 to July 2017. Total 60 patients were included in the study after the fulfilment of the eligibility criteria and the written informed consent given by the study subjects. A total of 44 PPIUCD insertion were done, out of these 24 (54.54%) insertions were intra caesarean and 20 (45.45%) IUCD were placed after vaginal delivery. All these women were asked to come for follow up at 6wk, 6 month and 12 months postpartum. In group 1 and 2 IUCD was introduced with help of Kelly`s forcep. In group 3 interval IUCD was introduced using no touch technique. In every visit pelvic examination was done to look for any abnormality. When all the patient reviewed at the end of all follow up visit, complication, removal,
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Prevalence of postpartum depression and association with risk factors in a tertiary care hospital

Prevalence of postpartum depression and association with risk factors in a tertiary care hospital

The prevalence of postpartum depression amongst postnatal women admitted of Obstetrics unit of NSCB Medical College, Jabalpur (Madhya Pradesh) at 12.8%. Various predisposing factors like child care stress, anxiety during pregnancy, inadequate social support, stressful life events, and lack of partner support can be easily addressed by counselling of pregnant subjects and their families. Every antenatal clinic must have a separate section for counselling. The postnatal period during which the just delivered mothers are at high risk of developing PPD must be well covered by social workers to aid early identification of women likely to develop PPD. It is also important to address the stigma associated with psychiatric disorders.
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Migration of an intrauterine contraceptive device to the sigmoid colon: a case report

Migration of an intrauterine contraceptive device to the sigmoid colon: a case report

perforate through the uterine wall into the pelvic or abdominal cavity, or into adjacent organs. Numerous factors may affect perforation. IUD-related factors include the design and structural characteristics of the device, as well as the nature and rigidity or plasticity of the inserter. With regard to the patient, uterine size and position, inherent anatomic configuration and timing of the insertion relative to delivery or abortion are all important determinants of potential perforation. Although the incidence of uterine perforation varies with the type of IUD, the incidence of IUD perfora- tion has been estimated to be 0.87 per 1000 insertions 9 .
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Profile of intrauterine contraceptive device (IUCD) acceptors at the Rivers State University Teaching Hospital, Southern Nigeria

Profile of intrauterine contraceptive device (IUCD) acceptors at the Rivers State University Teaching Hospital, Southern Nigeria

In this study, all the IUCD insertions were done within seven days of onset of menstruation after ruling out pregnancy. This time of insertion is associated with less discomfort and is generally easier to perform as the cervical canal is dilated. In addition, insertion related bleeding is masked during this time of insertion. IUCDs can also be inserted immediately post-partum but not more than 48 hours after delivery and post abortion [12, 27]. In our study, there were no post abortal or post-partum insertions. Levonorgestrel releasing intrauterine system (LNG-IUS) is yet to be made available in the family planning clinic of the hospital. IUCD has been cited by some workers as the best emergency contraception. Though the awareness of its use as an emergency contraception in our centre is very low, none of the clients used the IUCD for emergency contraception.
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Comparative study of post partum intrauterine contraceptive device in vaginal and intra caesarean insertion

Comparative study of post partum intrauterine contraceptive device in vaginal and intra caesarean insertion

Before starting the procedure, again ensured that woman has given the informed written consent and all the necessary sterile equipments were ready and available e.g. Multiload 375, Sims speculum, 2 ring forceps, povidine iodine, cotton swab and Kelley’s placental forceps. Examination was carried out to rule out postpartum hemorrhage, extensive laceration and the uterine fundal height and its tone were also noted. Visualization of cervix was done by using Sim’s speculum. Vaginal walls and cervix were cleaned twice with povidone iodine solution. Anterior lip of cervix was grasped with help of ring forceps till first lock. By using no touch technique, Multiload 375 was held with long placental forceps with edge only so that it can be easily released from the instrument when opened. By using the ring forceps, gentle traction applied on the anterior lip of cervix and IUCD was inserted into lower uterine cavity without touching the vaginal walls. Once the placental forceps reached into the lower uterine cavity, ring forceps was lowered, left hand was placed on suprapubic area and finger towards fundus. Uterus was gently pushed upwards to straighten the uterine cavity (for high fundal placement of IUCD) and ring forceps was removed. Placental forceps with IUCD moved upward until the fundus was reached when resistance was felt. Placental forceps was opened and slightly tilted inwards to release the CUT at fundus. Forceps must be opened and swept to right during withdrawal which ensured that instrument was away from the IUCD. Uterus was stabilized until forceps removal was complete. Lastly examination of cervix was done to ensure that thread of CUT was not visible at cervical os. (If it is visible then the IUCD has not been properly placed at the fundus and needs reinsertion)
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Factors associated with removal of postpartum intrauterine contraceptive device among acceptors in rural areas of Nadia district, West Bengal: a case control study

Factors associated with removal of postpartum intrauterine contraceptive device among acceptors in rural areas of Nadia district, West Bengal: a case control study

randomly from each block i.e. a total of 16 subcentres were included in the study. Three cases and nine controls were planned to be taken from each sub-centre. Two separate sample frames were considered for PPIUCD removal and PPIUCD non-removal groups. These frames had been prepared by line listing of women who had been inserted with PPIUCD in the month of September and October 2018 of that particular sub-centre including their present status of PPIUCD (continuation/ spontaneous expulsion/ voluntary removal) with the help of RCH registers and the local staffs. From this frame, required number of cases and controls were selected randomly. A face to face interview by house to house visit had been conducted with a questionnaire. The questionnaire was first prepared in English. Then it was translated into Bengali by a linguistic expert keeping semantic equivalence. To check the translation, it was re-translated into English by two independent researchers who were unaware of the first English version. Face validity of each item had been checked from previous researches in the presence of public health experts. They also decided the content validity of each domain. Reliability was checked by test-retest method (r=0.9). Pretesting followed by pilot testing was conducted. Necessary corrections and modifications of the questionnaire were done accordingly.
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A FOLLOW-UP STUDY ON RATIONAL DRUG PRESCRIBING  AND DISPENSING IN OUTPATIENTS IN A TERTIARY CARE  TEACHING HOSPITAL OF WESTERN NEPAL

A FOLLOW-UP STUDY ON RATIONAL DRUG PRESCRIBING AND DISPENSING IN OUTPATIENTS IN A TERTIARY CARE TEACHING HOSPITAL OF WESTERN NEPAL

In this study, the common drugs prescribed were dermatological and topical drugs. A previous study in the same setting also reported a similar finding. 12 A study from this hospital identified anomalies in antimicrobial use in the Dermatology department. 15 Dermatology is an area where there can be a significant irrational use of medicines. One of the areas can be regarding prescribing fairness cream and cosmeceuticals. A group of authors from western Nepal had claimed that fairness creams can be a case of disease mongering. 16 Antimicrobials also accounted for 11.86% of the outpatient drugs. This finding was in agreement with the finding from our hospital two years back. 12 However, one should be careful while prescribing antibiotics. A study had reported that antibiotics were prescribed for viral fever 11 though it does not have a role in viral infections. A group of researchers from Switzerland recommend that an improvement in the availability of rapid diagnostic methods to distinguish viral from bacterial infections may help reduce the number of empiric therapies in favor of pathogen-targeted therapeutic treatments. 17 In order to improve rational use of antibiotics, the MTH publishes the sensitivity pattern of the common microbial isolates to commonly used antibiotics. This can help the clinicians in choosing better alternatives. 18
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The Impact of Women-Centered Counseling on Intrauterine Contraceptive Device Satisfaction and Continuation

The Impact of Women-Centered Counseling on Intrauterine Contraceptive Device Satisfaction and Continuation

The intrauterine contraceptive device (IUCD) is the world's most widely used spacing method which can be considered as the reversed birth control. Client-centered contraceptive counseling has expressed the adverse uses of this device in meeting the request for contraception and keeping the human rights safe. The goal of this research was to assess the impact of women-centered counseling on intrauterine contraceptive device satisfaction and continuation. A Quasi-experimental design was selected in carrying out this study, and a purposive sample of 200 women (100 received the women-centered counseling program about IUD, and 100 received the routine care of the health agency) were recruited for this study. Data collection consisted of : a structured interview sheet, assessment of women knowledge about IUCD sheet, assessment of believed rumors or misconceptions about IUCD sheet, the schedule of the follow up at the third and six months sheet, and women satisfaction scale. Results revealed that the higher percentage of women in both the study and control groups was among the ages of 25 to less than 35 years (50.0% and 41.0%). The difference observed was not statistically significant. The implementation of women-centered counseling program was successful in improving their knowledge, and the correction of believed rumors of IUD was compared to the pretest. The study group suffered from lesser side effects and complications during the follow-up phases than the control group. Also, backache and genital tract infections were more popular in the control group in comparison with the study group with a statistical significant difference. The vast majority of women (93.0%) in the study group had continuous use of IUD until the six month compared to 68.0% in the control group with a statistical significant difference. The most considerable majority of the female in the study group were highly satisfied with the provided services, the service providers, and the method itself (92.0%, 100.0% and 82.0% ; respectively). It could be concluded that, women who received counseling program on IUCD showed better satisfaction and continuation than those who did not extradite it. The study recommended that, counseling program can be recommended for females because it increases IUD uptake, decreases early removal of IUD, and increases the continuation and satisfaction for IUD use.
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Can We Predict Menorrhagia with Intrauterine Contraceptive Device (IUCD) Insertion?

Can We Predict Menorrhagia with Intrauterine Contraceptive Device (IUCD) Insertion?

Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without me- norrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical dis- orders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pul- satility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler in- dices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorr- hagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.
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