Background: PPH is the most common cause of maternal morbidity and mortality around the world. Incidence of PPH is 2-4% following vaginal delivery and 6% following cesarean delivery in India. Uterine atony is the most common cause of PPH. Treatment of PPH involves medical treatment and surgical management. In between medical and surgical management of PPH comes uterine balloon tamponade which is simple, less invasive and can be managed with minimal training.Methods: A retrospective cohort study was done for 2 years at Vanivilas hospital, Bangalore medical college and research centre, Bangalore, Karnataka. Cases of atonic PPH managed using Bakri balloon were included in the study. The objective of the study was to study the effectiveness of uterine balloon tamponade using Bakri balloon in the management of atonic PPH and to study the maternal outcome.Results: In this study total of 50 cases were included. Women were in the age group of 18 to 33years. Regarding obstetric history, 22 (44%) were primigravida and 28 (56%) was multigravida. Among these 50 cases 8 (16%) women had undergone caesarean delivery and 42(84%) had vaginal delivery. All women received blood transfusion, 17 (34%) received blood and blood components (like PRBC, FFP AND platelets) and 33 (66%) cases received only PRBC transfusion. In these 50 cases, 32 (64%) required ICU admission for monitoring, remaining 18 (36%) were monitored in the labor-room. Bakri balloon was effective in 49 cases among 50. Success rate was 98%.Conclusions: Intrauterine balloon tamponade using Bakri balloon is effective for control of atonic PPH in majority of cases.
Background: Unsafe abortions is causing about 8% of maternal deaths in India. So, it’s important to use contraception not only for spacing but also to prevent unintended pregnancies. It is well known that fertility is resumed in the immediate cycle following an abortion. Post abortal contraception is very important in preventing pregnancies in the immediate post-abortal period. This study was intended to know the acceptance of post-abortal contraception in women coming for medical termination of pregnancy (MTP) or following spontaneous abortion in tertiary care centre. Thus, it is vital to know the choices made by them, to know the method accepted so that it will be helpful in bringing awareness in those who do not opt for post-abortal contraception. Aims and objectives were to study the acceptance rate of post-abortal contraception. Also, to study the method of contraception accepted.Methods: It was a retrospective cohort study from 2018 to 2020 done in Vani Vilas hospital, BMCRI, a tertiary hospital. A total of 2273 patients were enrolled in the study. Data was collected from both 1st trimester and 2nd trimester abortion patients (spontaneous/induced) from the Comprehensive abortion care register. The acceptance and method of contraception accepted was studied. Inclusion criteria were-women coming to tertiary centre for abortion (spontaneous/induced) to Vani Vilas hospital. Exclusion criteria were-Molar pregnancy and Ectopic pregnancy. Demography, educational status, details of spontaneous or induced abortions, parity and gestational age at abortion, the acceptance and methods of contraception accepted were studied.Results: A total of 2273 patients were included in the study of which 738 were MTP and 1535 were cases of spontaneous abortion. 912 (40.12%) were primigravidae and 1361 (59.87%) were multigravida. Various methods of contraceptives were accepted by 1973 (86.80%) patients, whereas 300 (13.19%) did not opt for any method of contraception. Of 1973 patients,176 (7.7%) underwent sterilization.Conclusions: The acceptance rate of post-abortion contraceptive methods was good. Acceptance of COCs and LARC was almost similar in this study. Immediate acceptance of contraception in the post-abortal period is very crucial in reducing unintended pregnancies and abortions hence family planning services after abortion need to be strengthened.
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