Background and Aim: Postpartum intrauterine device (PPIUD) is a reversible, long-term and effective technique of contraception. The intrauterine device (IUD) is inserted within 48 hours of delivery. The immediate insertion of an intrauterine device causes certain complications. The present study aimed to assess the prevalence of complications after Interval Postpartum Intrauterine Device Insertion. Materials and Methods: This cross-sectional study was carried out on 147 women who underwent postpartum IUD (PPIUD) insertions during from January 2021 to June 2021 at Gynecology department, Mufti Mehmood Memorial Teaching Hospital (MMMTH), Dera Ismail Khan and Muhammad Teaching Hospital Peshawar. All the women who delivered and showed willingness for PPIUCD insertion were enrolled and continuously follow-up for 4 to 6 weeks after delivery. Demographic, obstetric, and clinical parameters were recorded on pre-designed medical proforma. PPIUCD insertion after 6 weeks of delivery were followed-up for the evaluation of complications. Uterine infection, medical removal of IUD, IUD expulsion, perforation, and method discontinuation were the outcome variables. SPSS version 20 was used for data analysis. Results: Of the total deliveries, 147 women inserted the postpartum intrauterine contraceptive device (PPIUCD). Of the total, about 122 (83%) women returned for follow-up after 6 weeks. All the women underwent transvaginal insertion of intrauterine contraceptive devices. The PPIUCD insertion related complications with prevalence were uterine infection 26 (21.3%), overall method suspension 17 (13.9%), perforation 20 (16.4%), interceptive uterine device expulsions 25 (20.5%), and intrauterine device removal 32 (26.2%). The severe uterine infection was in 2 (1.7%) cases who were hospitalized. Conclusion: The postpartum intrauterine device cumulative expulsion rate was higher among women compared to the expulsion rate of insertions. The longer duration of bloody lochia flow and delivery intrauterine device insertions were the key risk factors for expulsion of PPIUCD. Women can safely utilize intrauterine contraceptive devices with low complications beyond four week. Keywords: Postpartum intrauterine device; Complications; Intrauterine device expulsion
Objective: To determine the frequency of hypovitaminosis B12 in pregnant females presented with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration: The department of Gynaecology and Obstetrics, Category A Hospital, Batkhela Malakand and Muhammad Teaching Hospital, Peshawarfor the duration of six months from October 2020 to March 2021. Methodology: Total 190 pregnant women (95 GDM, 95 non-GDM) were enrolled in this study. Patient’s ages were ranging between 18 to 40 years. Detailed demographics including age, gestational age, body mass index (BMI), and gravidty were recorded after taking informed written consent. Blood samples were taken from all the patients for measuring vitamin B12 status. Hypovitaminosis B12 was defined as <300 pg/ml. Data was analyzed by SPSS 24.0. Results: Mean age of patients was 32.46±6.82 years. Mean BMI was 26.24±2.34 kg/m2. Mean gestational age was 34.56±2.18 weeks. 105 (55.26%) women were multigravida. 80 (42.11%) patients had vitamin B12 level <300 pg/ml. Patients with GDM had high rate of vitaminosis B12 deficiency as compared to non-GDM patients (65.26% Vs 18.95%). A significant association was observed between GDM and hypovitaminosis B12 with p-value <0.0001. Conclusion: Vitamin B12 deficiency was significantly associated with gestational diabetes mellitus with frequency of 65.26%. Keywords: Vitaminosis B12, Gestational Diabetes Mellitus, Pregnancy
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