Background: In India, 65% of women in the first year postpartum have an unmet need for family planning but only 26% of women are using any method of family planning during the first year postpartum. This leaves a huge gap which needs to be addressed if maternal health is to be optimized. This calls for a method which is both effective and acceptable immediately post-partum. This is where the role of PPIUCD needs to be studied.Methods: This study was a retrospective observational study conducted in a tertiary care hospital. All deliveries during the time period from September 2016 to August 2017 were included in the study and the women accepting PPIUCD were studied for analysed for their age, parity, booking status and complaints during the follow up visit.Results: A total of 13,039 deliveries took place in one year between Sept 2016 to Aug 2017 out of which, 1118 (8.6%) accepted PPIUCD as a method of contraception. 44.3% PPIUCD users were in the age group of 21-25 years. 57% of PPIUCD users were primigravidas. 84% of PPIUCD users were booked cases. Missing threads was the most common complication, with 8.4% patients reporting it at follow up. There were no major complications noted in the study.Conclusions: PPIUCD is a safe and effective long acting reversible contraception method. Is particularly beneficial in a setting where women do not return for contraceptive advice. With low expulsion rates and high continuation rate, authors can conclude that PPIUCD can be the solution to a country like India currently facing population crisis and high unmet need.
Broad ligament pregnancy is defined as gestation that grows in the space formed by anterior and posterior peritoneal folds of the broad ligament. We report a case of 30 years old lady admitted to our hospital with the diagnosis of gravida 2, para 1, live birth 1, with 24 weeks of gestation with low lying placenta with anhydramnios. She was taken up for lower segment cesarian section at 28 weeks gestation in view of low lying placenta with chorioamnionitis. The broad ligament pregnancy was diagnosed peroperatively after identifying the anatomical relationship of the pregnancy. Sac was excised and margins secured after extraction of the baby and placenta. Patient had an uneventful postoperative period. Broad ligament pregnancy may be missed in antenatal period but in cases of displaced cervix, early onset unexplained anhydramnios, and failed induction of labor, it may raise high suspicion. Laparotomy/ laparoscopic management is the mainstay of management of broad ligament pregnancy.
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