Evaluation of postnatal quality of life (QOL) has remained a poorly researched area in India. The present cross-sectional study assessed postnatal QOL, using the Mother Generated Index (MGI) and its associated risk factors, and was conducted during January-March 2013 among 274 mothers, 6-8 weeks postnatally. A semi-structured questionnaire was used to evaluate sociodemographic and obstetric characteristics and social support. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9) and QOL using the MGI. The vast majority (90.1 percent) of respondents in our study had a primary MGI score <5, those with significantly higher prevalence of physical problems and psychological distress. A total of 39.8 percent of respondents were screened as having other (not major) depressive symptoms and 4.7 percent as having major depressive symptoms. Multiple regression analysis revealed that age (β = 0.033, p = .018) and socioeconomic status (β = 0.156, p < .001) were significantly positively associated with QOL, while increased depressive symptom scores (β = -0.075, p < .001) were significantly negatively associated with QOL. A wide spectrum of QOL aspects were reported, including physical, emotional, social, and economic concerns by the mothers. Prevention, evaluation, and treatment of postnatal depressive symptoms and impaired QOL are warranted, taking into account the role of various biopsychosocial risk factors and specific concerns raised by the mothers.
Objective To compare TCu380Ag and TCu380A intrauterine contraceptive devices after 1 year of use. Methods A prospective randomized controlled trial was conducted among healthy married women aged 20–35 years who attended the family planning clinics of three tertiary centers in India between August 1, 2015, to March 31, 2018. The TCu380Ag group (n=300) received one of three sizes of this device depending on uterocervical length: maxi (8.0–9.0 cm), normal (7.0–8.5 cm), or mini (6.0–7.5 cm). The remaining 300 participants received TCu380A. Follow‐up was conducted at 3‐monthly intervals to assess continuation rate, acceptability, efficacy, adverse effects, and complications. Results The TCu380Ag group had a higher continuation rate than the TCu380A group at 1 year (84.0% vs 75.8%; P=0.01), with an efficacy of 99.6% versus 100.0% (P>0.05). Overall estimated continuation rates were 94.5% (95% confidence interval [CI] 91.7%–96.4%) and 88.4% (95% CI 83.2%–91.5%), respectively (P=0.026). Use of TCu380Ag was associated with fewer adverse effects (heavy menstrual bleeding, abdominal pain, or expulsion) when compared with TCu380A (P>0.05 for all comparisons). Discontinuation rates owing to adverse effects were 6.59% for TCu380Ag versus 13.26% for TCu380A (P=0.01). Conclusions Varying sizes of TCu380Ag could provide an alternative to TCu380A.
Objectives: To reduce the perinatal transmission of HIV AIDS in antenatal women-a need-based project with NACO protocols, with a series of interventions. Methods: Prospective and retrospective study, data collected from Parent-to-Child Transmission of HIV-AIDS records and case sheets. Women registered for pretest counseling in antenatal OP tested for HIV, posttest counseling given, single drug NVP administered to mother and neonate, exclusive breast feeding advised for first 6 months, and infant testing for HIV done at 18 months of age by ELISA. Results: Seroprevalence in antenatal women was 1.2%. Majority (95%) of mother-child pairs were administered single drug NVP. Institutional delivery rate for seropositive women was 70% and the perinatal transmission of HIV AIDS was 8%. Conclusion: Improve universal counseling and testing, more number of mother-baby pairs to be administered single drug NVP, increase institutional delivery rates for seropositive women, improve follow-up services with the help of outreach workers to reduce perinatal transmission of HIV AIDS.
Background: There has been a considerable increase in the rate of caesarean sections in the past few decades. Some demographers have argued that this increase is largely affected by the uprising trend of new medically indicated caesarean sections. M. S. Robson proposed a ten-group classification of caesarean sections in year 2001 which was appreciated by WHO in 2014 and FIGO in 2016. This classification is known as Robson’s classification which has ten groups.Methods: This is a retrospective study which was carried out at Civil Hospital, Karimnagar. The study group included all live births and still births of at least 500 gm birth weight or at least 28 weeks of gestation at Civil Hospital, Karimnagar during the period from October 2019 to December 2019. The data collected was analysed using simple statistical methods like percentage and proportion. The data was grouped according to the Robson’s 10 group classification system. The overall caesarean section rate, size of each group and the relative contribution of each group to the overall CS rate were calculated.Results: The total number of deliveries during the study period was 2493. Out of these, the number of caesarean deliveries was 1345. The caesarean section rate was calculated to be 53.95%. The group 5 (multiparous with at least one previous uterine scar with single cephalic pregnancy ≥37 weeks of gestation) contributed to 38.07% of the total caesarean section rate which is the highest.Conclusions: A regular audit into the number and indications of caesarean sections will definitely help in decreasing the primary and repeat caesarean sections.
Objective: To study the role of Indomethacin in patients with Idiopathic Polyhydramnios who were symptomatic. Methods: A prospective study was conducted in Prathima Institute of Medical Sciences, Karimnagar from September 2017 to May 2019. Eighteen patients with Idiopathic Polyhydramnios who presented with respiratory embarrassment, premature opening of os or presence of uterine activity were given Indomethacin orally at a dose of 25mg 6th hourly. The significance of changes in AFI was tested by paired t test. Results : There was significant improvement in the symptoms in all the eighteen patients. The mean age of the patients in our study was 26.4±5.5 years. The majority 14(77.7%) of women were multigravida. Mean gestational age at presentation was 30.78±1.56 weeks. Mean AFI at presentation was 31.56±3.68 cm. Indomethacin was given orally at a dose of 25mg, every 6th hourly for a mean duration of 22.5±6.38 days. Mean AFI at the end of treatment was 20.28±5.64 cm. Pregnancy was prolonged by an average of 5.5±1.89 weeks. The difference in AFI at the end of treatment was statistically significant (p<0.05). Oligohydramnios was seen in one patient. Mean gestational age at delivery was 36.28±1.41 weeks. 17(94.4%) of them had good neonatal outcome. There was one neonatal death at< 7 days of birth. Conclusion: Indomethacin significantly decreases amniotic fluid volume in patients with Idiopathic Polyhydramnios and relieves symptoms but close surveillance is necessary.
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