Objective: To assess what impact does primary physician counseling have on contraceptive uptake. Study Design: Cross-sectional Comparative study. Setting: Study was done in three semi – government hospitals in three different cities. Period: April 2022 to May 2022. Material & Methods: Patients in outpatient clinics of the hospitals were given a questionnaire by simple random sampling. It was to assess women for their current use of contraception based on the source of their information about contraception. These groups were compared with each other for their contraception uptake. Associations between education, parity, working status and contraception use was also sought. The sample size was 175 women. Results: Out of 175 participants, 74 (42.3%) were practicing contraception at the time and 53 (30.3%) did not know about contraception. Reasons for not using contraception included side effects 71 (40.6%), Doctor never told them 56 (32%) and husband not willing 50 (28.6%). More women were of parity 4 or less (58 vs 34) and more working women used contraception (16 vs 6). The difference was not statistically significant. Illiterate women used contraceptives less. With education, there was significantly more use (38 vs 10) p < 0.001. Most Women knew about contraception from neighbor/ relatives 57 (32.5%) and 41 (23.4%) did not practice any method. A doctor/health professional was the source in 37 (21.2%), only 12 (6.9%) did not adopt contraception with p = 0.003. There was a strong statistical significance. Conclusion: There was a strong association between the physician counseling and contraceptive use. There is a strong need of regular, persistent contraceptive advice during each antenatal visit to individualize a contraception plan to suit a couple.
Objective: To assess the impact of fetal echocardiography in altering the course of action for neonatal cardiac expertise and services available in Pakistan following an antenatal diagnosis of congenital heart defect (CHD). Study Design: Cross-sectional study. Place and Duration of Study: Pediatric Cardiology Unit, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi Pakistan, from Feb 2020 to Sep 2021. Methodology: Fetuses aged 18 to 38 weeks of gestational age referred to the Pediatric Cardiac Unit due to risk of or suspicion of congenital heart disease underwent fetal cardiac echo. Data were collected and reviewed retrospectively to seek any impact of the antenatal diagnosis on post-natal planning.Results: The mean age of the mothers was 29.79±5.24 years (range, 17-47 years), and the mean gestational age at which the fetal echocardiography examination was performed was 27.29±4.47weeks (range: 12–38 years). Of the 609 pregnancies, fetal echocardiogram evaluation was performed, and sixty-three (10.3%) fetal echocardiograms were abnormal. Of the 63, only 06(9.5%) returned to the neonatal cardiac unit for follow-up and treatment in the first ten days of life. Conclusion: The real impact of fetal echocardiography is possible only with the availability of well-developed, readily accessible fetal and neonatal cardiac services. Poverty and a struggling healthcare infrastructure confound the benefits.
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