Background: Among developing countries, India holds the second place in being the most populated country accounting to 1.3 billion. This addresses the need for effective population control by implementing various family planning and contraceptive services thereby improving the quality of life. Our study aims at assessing the factors influencing the awareness and acceptance of permanent method of family planning.Methods: This is a questionnaire based cross sectional study carried out in A.J. institute of Medical Sciences on 300 postpartum women who have undergone two or more child births.Results: 77.3% of women were aware of family planning services out of which 64.3% had knowledge about permanent method of sterilization. 73% preferred to undergo tubectomy whereas only 13.7% were willing for vasectomy with the main reason for refusal being fear of surgery (25.9%). 32.6% of women wanted their husbands to undergo vasectomy rather than having a tubectomy themselves. Desire for more children (39%) was the main reason given by most women who refused to undergo tubectomy.Conclusions: Though women were aware of contraceptive practices, proper knowledge about permanent methods of family planning was still inadequate especially regarding vasectomy. Our study showed that lack of awareness and knowledge, fear of adverse effects, fear of sexual dysfunction, culture and religious beliefs, opposition from the male partner and health concerns were the factors influencing tubectomy acceptance over vasectomy as a permanent method of sterilization.

Background: Menopause is defined as complete cessation of menses for a period of twelve months or more as a result of complete loss of ovarian follicular activity. Issues related to menopausal symptoms are complicated in terms of experience, severity, and dynamics of the symptoms. Various studies had showed that these symptoms vary among individuals depending on the menopausal stage, ethnicity, geographic location, and other factors menopause rating scale is an effective tool to assess the severity of these symptoms. The aims and objectives of this study were to assess the commonly reported menopausal symptoms among the women of Dakshina Kannada district using a modified menopause rating scale.Methods: This study was conducted in A.J Institute of Medical Sciences and Research Centre from January 2019. A total of 360 postmenopausal women were interviewed using predesigned questionnaire. Menopausal symptoms were assessed using modified menopause rating scale.Results: Majority of women attained menopause at the age of 51-55 years and the calculated mean age was 51.33+3.36. 85% were symptomatic with at least one symptom. The most common symptom reported was joint and muscular discomfort (80%), psychological symptoms like depressive mood (68%), vasomotor symptoms (60%), sleep disorders (50%) urogenital problem (30%). The menopausal symptoms were more prevalent in women of lower socioeconomic status and the ones who were illiterate and this difference was significant.Conclusions: There is an increasing need for establishment of specific health intervention for postmenopausal women by specialty clinics as the burden of menopausal symptoms is high in the Indian women due to lack of awareness, socio cultural and economic factors, and inaccessibility of health services, which may negatively affect the attitude of women towards menopause.

Background: Placenta previa describes when a placenta is implanted partially or completely over the internal OS. About one third of the ante partum haemorrhage belongs to placenta previa. The incidence is increased beyond the age of 35 years, with high birth order pregnancies, prior caesarean deliveries and in multiple pregnancy. The aim of the study was to determine maternal and fetal outcome in pregnancies complicated with placenta previa.Methods: A 3 year retrospective study done in OBG department of A. J. Institute of Medical Sciences, Mangalore from January 2017- January 2020. All pregnant women who are diagnosed with placenta previa during regular antenatal care (ANC) follow up, at or after admission and during caesarean delivery are included in the study. Data were collected from the hospital records.Results: During the study period, there were 34 pregnant women with placenta previa. Maximum were in the age group of 31-35 years of age and 8.82 percentage were in the age group more than 35 years. Out of the study subjects,76.5 percentage were multigravidas and 50 percentage were giving history of prior one caesarean section. 29.4 percentage of study subjects had true placenta previa and 85.2 percentage underwent elective caesarean section. There were significantly higher number of babies required neonatal intensive care unit (NICU) admissions.Conclusions: An increase in the incidence of women with advanced maternal age, multiparity, prior caesarean deliveries contributes to a rise in the number of pregnancies complicated with placenta previa.

Background: Several models have been proposed to predict the need for an LSCS. With reference to this, the impact of the size of the fetal head traversing the birth canal is an important determinant of delivery outcomes. We examined the association between the head circumference and mode of delivery and perinatal outcomes, when compared to birth weight predicted by scan.Methods: This was a retrospective study, on 800 electronic delivery records between December 2019 and May 2021. Sociodemographic data, obstetrical parameter, term scan findings of head circumference and estimated fetal weight, and labour and perinatal outcomes were collected and analysed.Results: HC >95th centile was found to be comparatively more predictive and statistically significant compared to EFW >95th centile in the prediction of LSCS, with the most common indication being cephalopelvic disproportion. Prolonged second stage of labour was statistically significant in both cohort A and B, undergoing vaginal delivery. It was also noted that a significant number of newborns in cohort A required NICU admissions, while NICU admissions after emergency LSCS was significantly higher in the cohort B (p=0.0032) though the overall 5 and 10 minute APGAR scores and duration of stay were comparable in the groups classified on basis of EFW and HC.Conclusions: The above statistics observed on an Indian population may aid obstetricians in the planning of the mode of delivery, improve pre-labor counselling and efficient management of mothers of large babies.

Iron deficiency is the most common cause of anaemia worldwide and is associated with significant maternal and fetal morbidity. Current options for treatment include oral iron supplementation which can be ineffective and poorly tolerated, intravenous iron which can be used in patients who are intolerant to or unresponsive to oral iron and red blood cell transfusions which carry an inherent risk because of which it should be avoided. Intravenous iron therapy may reduce the requirement for allogenic blood transfusion. Ferric carboxymaltose is a new intravenous iron formulation promising to be more effective and as safe as iron sucrose. It may even have a better compliance as it offers the administration of a much higher iron dosage at a time.The study was designed to compare the efficacy and safety of IV ferric carboxymaltose versus iron sucrose in the treatment of iron deficiency anaemia of pregnant women with moderate anaemia in the second and third trimester.A hospital based randomized prospective study was done from July 2013 to June 2015 in the department of Obstetrics and Gynaecology, A.J. Institute of Medical Sciences, Mangalore. Baseline haemoglobin, peripheral smear and serum ferritin levels were measured to diagnose iron deficiency anaemia. 60 pregnant women who met the inclusion criteria and who formed the study subjects were randomly allocated into two groups comprising of 30 in Group C (Received ferric carboxymaltose) and 30 in Group S (Received iron sucrose). Outcome was assessed by measuring haemoglobin 3 weeks after treatment and a comparison of the safety and efficacy between the two groups was made. In the present study the commonest age group was 21 to 30 years: 80% in group C and 73.3% in group S and mean age of the study population in group C and S was comparable (25.2±3.54 vs 24.8±4.58 years). The socio demographic characteristics, obstetric history, vitals and pretreatment haemoglobin were comparable in both the groups (p>0.050). The post treatment haemoglobin levels in 63.3% of the women in group C compared to 46.7% in group S were found to be 11 or more and mean post treatment haemoglobin levels were comparable in group C and group S (11.016±0.789 vs 10.73±0.821 gm%; p=0.174). In the present study, post treatment mean increase in haemoglobin levels was noted between 2.0 to 2.5 gm% in 43.3% of the women in group C compared to 50.0% in group S. Ferric carboxymaltose administration in pregnant women in the second and third trimesters is well tolerated and is not associated with any clinical safety concerns. Both ferric carboxymaltose and iron sucrose have a comparable safety profile even when ferric carboxymaltose was administered in a much higher dosage compared to iron sucrose. Ferric carboxymaltose should be considered as the drug of choice, if i.v. iron treatment becomes necessary in the second or third trimester of pregnancy.