A cross sectional study on willingness and acceptabily: PPIUCD by primipara mothers at a tertiary care hospital, Tamil Nadu

Background: Postpartum intrauterine contraceptive device is a postpartum family planning method which provides spacing to the next pregnancy and also it helps to avoid unwanted / unintended pregnancy during postpartum period. Our aim was to study the willingness and acceptability of Postpartum intrauterine contraceptive device among primi paraous women and compare them as a factor of route of insertion (vaginal versus caesarean).Methods: A cross sectional analytical study was done in a tertiary care teaching institution to know the willingness and acceptance among primi paraous delivery (either vaginal and caesarean deliveries) for the period of three months using the hospital records that a total number of 587 primi paraous deliveries and among them 433 mothers had Postpartum intrauterine contraceptive device over the three months period, were taken as a secondary data and studied for their willingness and acceptance for Postpartum intrauterine contraceptive device.Results: 82.8 % of primi paraous women were showing willingness for Postpartum intrauterine contraceptive device and 73.8 % of them had Postpartum intrauterine contraceptive device insertion. Postpartum intrauterine contraceptive device insertions were more in caesarean deliveries than in vaginal deliveries of mothers with one child.Conclusions: Postpartum intrauterine contraceptive device is a strong weapon in the family planning and should be encouraged in both vaginal and caesarean deliveries. The acceptability of Postpartum intrauterine contraceptive device in women with one child was effective and statistically significant at p value is < 0.05

A cross sectional study on willingness and acceptance of postpartum sterilization by mothers at a tertiary hospital

Background: India was the first country in the world to launch the Family Planning Programme in 1951. Despite this fact, India still lags behind in practicing contraception and limiting family size. Even though various measures for encouraging the usage of contraception have been taken up, the achievement in this field is not up to the expectation due to various social and cultural factors. The aim of our study is to estimate the prevalence of awareness, willingness and acceptance of postpartum sterilization among mothers who delivered with two and more children before discharge at a tertiary hospital.Methods: It is a cross sectional study using the survey data on uncovered mothers who are discharged without accepting sterilization and mothers who underwent sterilization in a tertiary hospital.Results: Total number of mothers with 2 and more living children was 231. All the mothers were aware of female sterilization method. Only 38.5% mothers underwent sterilization. 66.9% of mothers stated willingness for sterilization but not done among the uncovered mothers with 2 and more children. This disparity was due to various medical reasons (pediatric opinion 57.7%, anesthetist opinion 0.7%, not treated within 7 days of delivery 8.5%).Conclusions: In our study, the awareness of female sterilization in women was 100%. 79.6% of them were willing for sterilization. Women willing for sterilization were more in caesarean section (45.4%) than in women who delivered vaginally (34.2%)

Delivery by repeat caesarean section today: an overview

Background: To find out the maternal and neonatal outcome and background characteristics of women delivering by repeat caesarean section in a tertiary care centre in Chennai, South India.Methods: Parturition records for the year 2017, were accessed and case records, for the calculated sample size were selected. Demographic features, obstetric history, gestational age and antenatal complications were recorded. Maternal outcome and baby details including sex of the baby, birth weight, APGAR and admission to New born Intensive Care Unit (NICU) data and acceptance of postpartum contraception was noted.Results: In the study group, 156 women delivered by repeat caesarean section.  The age group of women ranged from 20 years to 38 years.  Majority of 83.4% of women were Para one.  Threatening rupture was recorded in 2.6% of women. The risk of previous two CS scars was noted in 3.2% of women. More than 41% of women had other complications. Most often observed complications were Gestational hypertension, Gestational diabetes, preeclampsia and eclampsia. Pregnancy complications of oligohydramnios, twins, breech and abnormal presentation, were significant. 1% of women had associated medical complications of anaemia and hypothyroidism.  Maternal and Fetal causes were the most important indication for caesarean section in 74% of women. There were no maternal deaths in present study group. Postpartum contraception was accepted by 55 % of women.Conclusions: Majority of repeat caesarean section was observed most commonly in para one women in the age group of 26-30 years More than 41% of women had associated medical and obstetric complications. There were no maternal deaths in this study. Neonatal deaths were 2.5%

Prevention of cervical cancer: early detection of precancerous lesions of cervix in women from a marginalized environment

Background: The objective of the present study was to find out the efficacy of low-cost methods, available for screening for cervical cancer and early detection of precancerous lesions, of cervix.Methods: The study with power above 80%, was conducted over a period of almost three years. Women aged below fifty years were included in the study. A total of 100 women were diagnosed with cervical intraepithelial neoplasia (CIN) and 244 women with chronic cervicitis by histopathological examination reports. Ten women were HIV positive.   Results: Low cost screening tests of visual inspection of cervix after application of 5% acetic acid (VIA) and visual inspection of cervix after application of Lugol’s iodine (VILI) were positive in 75% of women with CIN and in combination with colposcopy, positive in 93%. The diagnostic accuracy of colposcopy was highest at 86%. (Odds ratio-.48.79).Conclusions: Initial screening for younger women with fewer years of exposure, the low cost tests, VIA / VILI  could be used under low magnification. Colposcopy should be done for all women with positive tests. The costlier human papilloma virus (HPV) tests should be done at cost effective purpose for high risk groups and when indicated, for early detection of precancerous lesions of cervix and prevention of cervical cancer