Objective: To compare the clinical performance and side effects of Implant (jadelle) and intrauterine contraceptive device (Cu-T). Study Design: Prospective Analytic study. Setting: Department of Obstetrics & Gynaecology, PNS Shifa Hospital, Bahria University of Health Sciences, Karachi. Period: 1st January 2021 to 31st December 2021. Material & Methods: A total of 162 married females of childbearing age participated in our study, n=81 in each group. Group A consisted of those females who had subdermal implant jadelle inserted and Group B included those ladies who were using intrauterine devices (IUDs) for contraception. Patient with pre-existing medical disrorders and those using levonorgestrel Intrauterine system (Mirena) were excluded. They were interviewed using a structured questionnaire at 6-months post insertion. The outcome were success/ failure rate and side effects. Data was analysed using SPSS 22. Results: A total of 162 women were part of this study. Most, 30(37.03%) were between 26-30 years in age in Group A (Implant) vs. 36 (44.4%) in Group B Intrauterine devices. 56 (61.7%) in Group A vs. 68 (83.9%) in Group B had regular menstruation prior to use of LARC; p-value 0.05 which is statistically significant. 45 (55.5%) in Group A vs. 33 (40.7%) in Group B had at least secondary level of education. Among the two study groups, 12(14.8) of Group A vs. 24 (29.6%) of Group B reported mild increase in menstrual bleeding, p-value 0. 000. Other side effects noticed were headache, nausea, and weight gain. Conclusion: Progesterone only subdermal implant showed same efficacy as Copper T IUD (intrauterine devices) with significantly fewer side effects.
Background: Ectopic pregnancy is a lethal condition and a gynecological emergency. It is associated with maternal morbidity and mortality with pregnancy loss. The incidence of ectopic pregnancy is increasing worldwide. The diagnosis of the ectopic pregnancy can be difficult without the suspicion of the condition. It is confused with the pelvic inflammatory disease and miscarriage. Objective: This study may help on formulating a guiding principle on the diagnosis and management of Ectopic pregnancies in this area. In this research the frequency of clinical presentations and factors responsible for ectopic pregnancy are determined. Methodology: This is a cross-sectional based study. This study was conducted at the Obstetricians and gynecology department of Murshid Hospital and health care Center Karachi. The 125 women diagnosed with ectopic pregnancy for the duration of six months from July 2021 to December 2021were included. Patients were examined for outcome variables (abdominal pain, vaginal bleeding, history of infertility, use of IUCD and previous ectopic pregnancy) noted in predesigned performa. Results: - The women mean age was 9m31 ± 6.6 years. There were 96 (78.4%) women observed with abdominal pain and 72 (57.6%) women with vaginal bleeding in which some of them had both clinical presentations. History of fertility 34 (27.2%), use of intrauterine contraceptive device 58 (46.4%) and previous ectopic pregnancy 33 (26.4%) were responsible for ectopic pregnancy. Conclusion: Majority of the patients attended the hospital were in acute condition. They were diagnosed with classical features of ruptured ectopic pregnancy. The most common clinical features were use of IUD, infertility history, and previous ectopic pregnancy. . For reducing the morbidity and mortality rates associated with the ectopic pregnancy the early diagnosis of the tubal rupture is an essential factor. Keywords: Ectopic pregnancy, vaginal bleeding, intrauterine contraceptive device
Objective: To determine the factors associated with maternal near-miss in booked patients managed at tertiary care hospital. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital Malir Cantt from Jun 2019 to Jul 2021. Methodology: A total of 198 pregnant women of were included in the study. All the women were followed until delivery, and data was collected for near maternal miss and types of complications. Relationship of the age of study participants, gestation, parity and presence of comorbid medical illnesses were analysed with maternal near-miss in our study participants. Results: Out of 198 pregnant women included in the study, 168 (84.8%) did not have near-miss, while 30 (15.2%) had experienced at least one near-miss. The mean age of the women included in our study was 29.236 ± 2.45 years. Cardiovascular complications 14 (7.1%) were the most common in our study participants, followed by renal complications 8 (4.1%). The second and third trimesters and the presence of medical comorbidities were statistically significantly associated with nearmiss (p-value <0.05). Conclusion: Near miss was a fairly common finding in booked pregnancies managed at our hospital. Women in the second or third trimester of pregnancy and those with any medical conditions had more chances of having near-miss than those in the first trimester or without any medical comorbidities.
Background: The knowledge, awareness and acceptance regarding contraceptives are variable in different parts of world. Family planning is still considered a stigma in most parts of the world. Contraceptive use for family planning is a key to understand the profound changes in fertility and to improve reproductive health worldwide. Objective: To evaluate the awareness and acceptance of the post-partum intrauterine contraceptive Device Insertion (PPIUCD) among the pregnant women visiting the Outdoor Department of Obstetrics and Gynecology in a tertiary care Hospital Malir Cantt Karachi. Study design and setting: A cross sectional study was conducted during the period January 2022- June 2022. Material and Methods: This cross sectional study was conducted at the Tertiary care Hospital, Malir cantt, Karachi, for six months from (January 2022-June 2022) Data were collected using interviewer administered structured questionnaire was filled after the informed consent. The inclusion criteria: were the women agreed to participate the study and agreed to fill the questionnaires Urdu version, who visited outdoor department. The exclusion criteria were the women who refuse to ill the questionnaire. Results: This study shows the acceptance rate of PPIUCD is 12% of 200 women who participated this study. The commonest reasons for their denial were the inadequate information or knowledge of PPIUCD. The acceptance rate of PPIUCD was associated with their awareness and the long term effectiveness. Women who have completed their secondary or higher education were more informed and accepted than uneducated women. (AOR = 3, CI = 11.81, 53.91). The age group ranging from 25-30 years showed positive acceptance for PPIUCD. Conclusion: The rate of acceptance for postpartum intrauterine contraceptive device turns out to be low in this study, though this is an effective and safe method of postpartum family planning. The perceived concerns and fears about the PPIUCD are due to lack of awareness regarding its use among women attending the antenatal clinics. Keywords: PPIUCD, Contraception, Postpartum FP, awareness.
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