Objectives:The primary objective of the following study is to determine the demographic patterns of women presenting as sterilization-failure and secondary is to evaluate possible etiological factors for failure and lay standard guidelines to reduce failure rate.Materials and Methods:The present study is retrospective study conducted in Department of Obstetrics and Gynecology, Government Medical College and Hospital-based on the case records maintained in our institution over a decade (April 2002-March 2012).Results:Over a decade, 140 cases of sterilization-failure with longest interval of 20 years have been documented out of 80 (57.14%) cases were of minilaparotomy (minilap), 53 (37.86%) laparoscopic tubal ligation and 5 (3.57%) were lower segment cesarean section. In 84 cases (60%) sterilization were performed in Primary Health Centre (PHC). Only 58 (41.43%) patients reported failure in 1st trimester (<12 weeks). 14 cases (10%) were of ectopic pregnancy. There were 25 cases (17.86%) of spontaneous recanalization. In 27 cases (19.29%) failure was due to improper surgical procedure and rest 54 (38.57%) have conceived due to tuboperitoneal fistula.Conclusion:Female sterilization even though considered as permanent method of contraception, recanalization is possible even 20 years after procedure. Maximum cases of failure were with minilap and those were performed at PHC. The most common cause of failure was tuboperitoneal fistula. Ectopic pregnancies were seen in 10% of cases. Proper counseling of patient is must. There is a need to stick to standards of sterilization procedure to prevent future failure.

Background: This study was undertaken to know the awareness of contraception in postnatal women in a Government Hospital in Maharashtra.Methods: Authors conducted a prospective study in Department of Obstetrics and Gynecology at Government hospital, Miraj between January 2015 to September 2016. All postnatal patients in this hospital, willing to participate in the study were included in the study after a thorough written informed consent. Patients were given pre decided questions for answering. Answers were noted, counselling was done.Results: Out of 4860 women, 97% of the women were aware of at least 1 contraceptive method, the highest being of female sterilization (91%) 20.8% of women had ever used the contraception before and most of them used it in between pregnancies (64.4%). 79.2% had not used any contraception before and main reason for not using was found to be, they wanted to conceive (46%) followed by fear of side effects (24.7%) Regarding willingness to use the contraception after counselling, 48.5% of women said they were not sure. Among rest 51.4% women, female sterilization (32.4%) was preferred method followed by copper-T (22.8%) The most common source of information was by media and books which was 39.3%.Conclusions: There is a large lacuna between the awareness and practice of contraception. Proper education of both partners, increasing female literacy, socio economic upliftment, effective health care system is needed.

Background: India was the first country in the world to launch a family planning programme, as early as 1952, with the main aim of controlling its population. Depot medroxy progesterone acetate, or DMPA is a progestin-only method of contraception. It is a 3-monthly intramuscular injectable that delivers 150 mg of medroxyprogesterone acetate in microcrystalline suspension form that delays absorption of the hormone after the injection. It provides long acting, effective and reversible contraception. In this study, we evaluated patients in reproductive age group 18-35 years who were willing to use injectable DMPA as a method of contraception to study the acceptance, compliance and efficacy of injection depot medroxyprogesterone acetate as contraception.Methods: It is a prospective observational study carried out at Government medical college Miraj on 150 patients who fulfil the inclusion criteria. The postpartum, interval and postabortal categorisation of patients done and they are councelled about the benefits and side effects and drawbacks of DMPA. Injection is given deep intramuscularly after written informed consent and a DMPA card is given to beneficiary. Follow up date explained and patients are observed for follow up and any evidence of bleeding weight gain or any other side effects of DMPA are noted.Results: The mean age of subjects was 24.48±3.494 years. 2) 3.3% of the patients were nullipara, primi para 46.7%, 36% were second para, 11.3%  were third para and  2.7% were fourth par. 3) After 1st injection, 47.3% patients were lost to follow-up i.e., they did not turn up for their second dose of injection. 4) Out of 150 patients who accepted the injection as contraception, only 79 patients turned up for their 2nd injection after 3months, out of which only 37 patients turned up for their 3rd dose of injection after 6 months and only 5 patients turned up for their 3rd injection. Thus showing that the compliance is poor among this study population. 5) At 2nd injection, 39.2% discontinued due to amenorrhea, 10.7% discontinued due to irregular bleeding, 18.5% due to weight gain and 31.6% due undergoing permanent method. 6) No patients who came for follow up reported any pregnancies during the course of injection, therefore the efficacy of injection depot medroxy-progesterone acetate, as a method of contraception is 100% in this study.Conclusions: The DMPA is a good method of long acting reversible method of contraception with good acceptance and efficacy with less compliance.

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Adnexal masses originate in the ovaries, fallopian tubes or surrounding tissue. Adnexal masses can be found in women of any age and pregnancy is no exception. Reasons for adnexal masses going undiagnosed in antenatal period are asymptomatic and small (≤5 cm) mass size; the pregnant patients refused a pelvic examination and a transvaginal USG examination for the fear of abortion during early pregnancy. In 3rd trimester ultrasound, a gravid uterus may obscure the correct visualization and detection of an adnexal mass or it is often missed when we keep our focus on the baby and placenta. As there is also increase in caesarean section rate, the incidence has also increased. Here we presented a case series of 4 different cases, we had described variety of adnexal masses which were diagnosed accidentally during caesarean section and also about their management. Case 1-dermoid cyst, case 2-para ovarian cyst, case 3-complex cyst, case 4-includes 3 cases of simple cyst. Adnexal masses arising in pregnancy are functional, asymptomatic and resolve spontaneously. The risk of malignancy in persistent adnexal masses is low and ultrasonography is the preferred method to assess this risk. If the pathology is incidental finding in caesarean section, it is to be removed in the same setting to avoid surgery later.