Objective To determine intrauterine contraceptive device (IUCD) discontinuation rate and its causes and related factors among women attending the OPD/family planning clinic in Mahila Chikitasalaya, SMS Medical College, Jaipur from January 2012 to December 2012. Methods 387 women who had an intrauterine device (IUD) inserted during the last 1-5 years were interviewed during their visits to the OPD/family planning clinic. Sociodemographic characteristics for all women were described using frequency distribution. Life tables were used to describe the proportion of women who discontinued IUD at various time intervals. The main outcome measure was IUD discontinuation. Results The incidence of IUD discontinuation in the first year following insertion was 16.79 %. Approximately 31 % of the study sample continued using their devices after 5 years. The average duration of IUD use was 36 months. Of the 387 women, 56 % discontinued IUD use because of a desire to conceive, 27.7 % because of side effects, 15.36 % because of opposition from the woman's family, and 1.5 % because they were sexually inactive. The most common side effects reported as the reasons for discontinuation were bleeding, infection, and pain. Discontinuation was inversely related to the age at insertion, the number of living children, and the sex of children. Previous contraceptive users were significantly less likely to discontinue IUD use. Conclusions The crude cumulative rate of IUD discontinuation was 16.79 % during the first year, suggesting a need to tackle the problem of discontinuation through effective educational strategies and counseling techniques. Desire to have a male child still predominates among Indian families. The average duration of IUD use in majority of the females was about 36 months (45 %), thereby fulfilling its objective of spacing between children as laid down by the WHO (2 years spacing between pregnancies). About 31 % of the women continued using IUCD even after 5 years. It is crucial to correct misconceptions and identify the lack of correct and complete information both among the providers and the acceptors, to improve the effectiveness of family planning programs.

INTRODUCTIONIndia is the second most populated country in the world after China with an estimated total population of 1.26 billion. India's maternal mortality ratio stays at an alarming figure of 254/100000 live births, which cause 1,17,000 women to die from pregnancy and child birth complications every year. This contributes to 20% of global maternal deaths. 1In India, 65% of women in the first year postpartum have an unmet need for family planning.2 Intrauterine devices (IUDs) have been used by women in India for decades for spacing pregnancy. Copper IUDs are the most commonly used type of IUD and the Cu T 380A has been found to be most effective IUD available in govt. sector free of charge. 3Appropriate times for IUCD insertion in the postpartum periods include the postplacental IUCD insertion, the immediate postpartum IUCD insertion and the transcaesarean IUCD insertion. Taking advantage of the immediate postpartum period for counselling on family planning, IUCD is a good option as a contraceptive method. The increased institutional deliveries provide the opportunity to provide women easy access to immediate PPIUCD services. The National Family Health Survey (2005)(2006) reported that 61% of births were spaced less than 3yrs in India. Unmet need is greater in 1st year postpartum. Only 3-5% of post-partum women wants another child within two years. 4 To address the unmet need during the post-partum period the Ministry of Health and Family Welfare, Government of India developed a national strategy to expand PostPartum Intrauterine Device (PPIUD) services among public sector facilities. Since, not much work has been done in assessing the complications and side effects of PPIUCD in caesarean and vaginal deliveries, we decided to undertake this study. ABSTRACT Background:The IUCD is a safe and effective contraceptive option for postpartum women who wish to either space or limit subsequent births. Methods: In a hospital based prospective observational, study we compared outcome of post placental IUCD in vaginal and caesarean delivery groups. Results: We found that expulsion rate is significantly higher in vaginal group (10%) as compared to caesarean delivery (2%) group at 3 months of follow up. Excessive bleeding is mostly commonly found complication (18% in both groups at 6weeks of follow up). Conclusions: Women who receive PPIUCD show a high level of satisfaction with this choice of contraception, and the rates of expulsion were low enough such that the benefits of contraceptive protection outweigh the potential inconvenience of needing to return for care for that subset of women.

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Introduction: Women diagnosed with HIV/AIDS may transmit the infection to their child during pregnancy, childbirth, or breastfeeding. However, the risk of mother-to-child transmission of HIV may be reduced by the use of antiretroviral therapy (ART). Objective: The main aim of the study is to appreciate the declining trend of HIV in babies with HIV positive mother by implementation of PPTCT services. Methodology: A retrospective study of detection of HIV positive mothers among all the antenatal patients attending OPD and including the patients coming in Emergency services and delivered at Mahila chikitsalaya, SMS Medical College, Jaipur from July 2008 to Dec 2017 was included in the study. They were screened for HIV status and further management of all HIV positive patients. Results: Total 220445 patients have attended OPD over 10 years from 2008 to 2017 among which total 150077 patients have tested for HIV (68.07%). Among these 240(0.15%) patients were found HIV reactive. From history, we could elicit sexual contact as a prime mode of infection in these women 198(82.50%), followed by blood transfusion in 31 (12.91%), and through needle injury/sharing in 11(4.58%). The CD4 count was more than 200 in 86% women. In total 240 patients 3 patients were aborted that were excluded. Out of 237 HIV-infected women, 35.02% (83) had a cesarean delivery and vaginal delivery was primary mode of delivery in 154(67.94%). HIV-infected women were more likely to have preterm, IUGR and anemia (16.45, 8.86%, 6.4%). There were no maternal mortality. Mean age of HIV positive women was 24.62±3.6 years. Mean parity was 1.72±0.48. In total 237 deliveries, 60(25.31%) babies were low birth weight. Mean birth weight was 2354.60±499g. Among total 154 vaginal deliveries, only 2 (1.29%) babies were found HIV ELISA positive at 18 months and in 83 LSCS, only 2 babies (2.40%) were found HIV positive. Among 237 deliveries, 229 babies (96.62%) were alive and rest 8 babies (3.37%) were still birth. In total 229 alive babies, 25 babies were admitted in NICU and early neonatal mortality occurs in 8 babies, and late neonatal mortality occurs in 6 babies. Among total alive 229 babies, 160(69.86%) babies were on breastfeed and 69(30.13%) babies were on top feed. Conclusion: Good antenatal care and multidisciplinary team approach can optimize pregnancy outcomes in HIV-infected women.

Background: Amniotic fluid plays a vital role during foetal life. The main purpose of this study was to evaluate the foetomaternal outcome in relation to amniotic fluid index in pregnant females beyond 36 weeks of gestation.Methods: This prospective type of study was conducted for one-year duration from May 2018 to May 2019 in 350 pregnant females beyond 36 weeks of gestation with clinically significant abnormal liquor volume. Clinical diagnosis was later on confirmed with ultrasonography and patients were categorized in three categories as patients with Amniotic fluid index (AFI) 5 to 24, AFI <5 and AFI > or = 25. Complete labour record was made and fetomaternal outcome was assessed.Results: In this study, incidence of oligohydramnios was found to be more than polyhydramnios at term. No significant differences were found in relation to age, parity, religion, residence and booking status in all the study groups. Mostly patients 119 (52%) delivered by caesarean section in oligohydramnios group whereas vaginal delivery was commonly seen in patients with normal AFI (80%) and polyhydramnios (55%). Growth restriction 59 (26%) and malpresentation 18 (8%) were commonly seen with oligohydramnios. In the polyhydramnios group, 14 (35%) babies had malformations whereas only 6 (3%) babies had malformations in patients with oligohydramnios. Significant differences were found in the foetal outcome between the patients with oligohydramnios and polyhydramnios in comparison to patients with normal AFI.Conclusions: In pregnant females with abnormal liquor volume increases the chances of maternal morbidity and perinatal morbidity and mortality.