Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

Background: Post partum contraception is the best evidence based intervention in prevention of pregnancy and abortion related maternal morbidity and mortality in the developing countries. The unmet need for contraception among women in the postpartum period can be effectively fulfilled by post partum insertion of IUCD, in a single visit under the Government scheme of providing free maternity services during institutional delivery. Despite optimal efforts by family planning program, very few couples are opting for spacing methods and lack of awareness has resulted in discontinuation of family planning methods particularly PPIUCD. This study is designed to study the practices of PPIUCD and causes for discontinuation at follow up in our hospital. The objectives of the study were study PPIUCD practices at Vanivilas hospital; causes for discontinuation of PPIUCD.Methods: Prospective study done at Vanivilas hospital attached to Bangalore Medical College and Research Institute from January 2014 to December 2014. Women admitted and delivered at VVH, were counselled. CuT 380A was inserted in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till June 2016.Results: There were 2072 PPIUCD insertions in one year, out of which 1244 were post placental, 139 were in immediate postpartum and 689 were intra caesarean insertions. Fifty four (54) women discontinued PPIUCD during follow up .Main causes for removal were menstrual abnormalities (19), pain abdomen (13), wanting sterilisation procedure (12) and marital disharmony.Conclusions: PPIUCD is an effective, safe, reversible method of long term contraception with high reported expulsion and low perforation rate, compared to interval insertion. More research is needed in the field of PPIUCD to enhance awareness and acceptance in the community. Awareness and counselling the eligible couples during ante natal care can improve acceptance and compliance of PPIUCD continuation rates

A study to identify the prevalence of vulvovaginal candidiasis in second trimester

Background: Vaginal candidial infections are due to excessive growth of Candida. These are normally present in the vagina in small numbers. Vaginal infections are typically caused by the yeast species Candida albicans. It is found that candidial infection increases the risk of preterm labour. Aims and objectives of the study were to determine the prevalence of vulvovaginal candidiasis and influence of maternal age, parity and weeks of 2nd trimester on its occurrence among pregnant women in 2nd trimester, attending the antenatal clinic in our hospital.Methods: A prospective study conducted in BMCRI for a period of 3 months (October 2019-December 2019) on patients in second trimester. Consent of patients taken. High vaginal swabs were collected from the pregnant patients in second trimester and sent for culture. Candida positive cases were noted and results were analysed.Results: A total of 100 high vaginal swabs were collected and reported in our study. Among them 54 swabs were positive for Candida growth (54%) and 46 swabs were negative for growth (46%). Culture positive patients’ clinical details were analysed and tabulated.Conclusions: Our study concluded that candidiasis is more prevalent in pregnant women but there was no statistical significance in occurrence of vaginal candidiasis among various age groups, parity or trimester. Hence it is better to screen all the patients in I early II trimester in order to find out and treat positive cases early to prevent preterm births attributed to vaginal candidiasis

A study to establish the prevalence of urinary tract infection in preterm labour

Background: Urinary tract infection (UTI) is one of the many etiological factors of preterm labour. Preterm labour is the onset of labour after 28 weeks and before 37 weeks of gestation. Preterm labour is a significant cause for perinatal morbidity and mortality. Hence early diagnosis and management of etiological factors is necessary. The most common bacterial infection encountered during pregnancy is UTIs. Early detection and management of UTIs may effectively prevent complications of preterm labour including preterm birth. Aims and objectives of the study was to estimate the prevalence of UTIs in preterm labour.Methods: cross sectional study with a total of 250 patients carried out in the department of obstetrics and gynaecology, Vanivilas hospital, BMCRI for a period of 6 moths-Aug 2019-Feb 2020. Patients in preterm labour i.e., cervical dilatation ≥1 cm, cervical effacement ≥80% with true labour pains were included in the study after taken informed consent form the patient. Detailed clinical history including age of patient, level of education, duration of antenatal care, parity, and obstetrical history was taken. Gestational age was calculated by LMP or early ultrasound. General examination, systemic examination and obstetric examination was done. Routine investigations were done along with clean catch midstream urine sample in a sterile container. Two samples were collected: 1st sample for microscopic examination, 2nd sample for culture and sensitivity.Conclusions: Untreated UTI can be associated with obstetric complications. The most common bacterial infection during pregnancy is UTIs. All women should be screened for UTI at the first antenatal visit. Once diagnosed it should be promptly treated with suitable antibiotic which is sensitive yet safest

Study on post partum intrauterine contraceptive device practices and causes for discontinuation of PPIUCD at follow up in a tertiary hospital

Background: Post partum contraception is the best evidence based intervention in prevention of pregnancy and abortion related maternal morbidity and mortality in the developing countries. The unmet need for contraception among women in the postpartum period can be effectively fulfilled by post partum insertion of IUCD, in a single visit under the Government scheme of providing free maternity services during institutional delivery. Despite optimal efforts by family planning program, very few couples are opting for spacing methods and lack of awareness has resulted in discontinuation of family planning methods particularly PPIUCD. This study is designed to study the practices of PPIUCD and causes for discontinuation at follow up in our hospital. The objectives of the study were study PPIUCD practices at Vanivilas hospital; causes for discontinuation of PPIUCD.Methods: Prospective study done at Vanivilas hospital attached to Bangalore Medical College and Research Institute from January 2014 to December 2014. Women admitted and delivered at VVH, were counselled. CuT 380A was inserted in accepters who fulfilled the Medical Eligibility Criteria and had no contraindications for PPIUCD. They were followed up till June 2016.Results: There were 2072 PPIUCD insertions in one year, out of which 1244 were post placental, 139 were in immediate postpartum and 689 were intra caesarean insertions. Fifty four (54) women discontinued PPIUCD during follow up .Main causes for removal were menstrual abnormalities (19), pain abdomen (13), wanting sterilisation procedure (12) and marital disharmony.Conclusions: PPIUCD is an effective, safe, reversible method of long term contraception with high reported expulsion and low perforation rate, compared to interval insertion. More research is needed in the field of PPIUCD to enhance awareness and acceptance in the community. Awareness and counselling the eligible couples during ante natal care can improve acceptance and compliance of PPIUCD continuation rates