Objective: This prospective observational study has been conducted to find out the efficacy and patient satisfaction of levonorgestrel intrauterine system (LNG-IUS), and it was compared with results of hysterectomy in perimenopausal Indian women with heavy menstrual bleeding (HMB).Methods: It was a prospective study conducted on 135 cases after taking consent. Patients were inserted with LNG-IUS, and the outcome in terms of further bleeding and quality of life was compared to that of hysterectomy.Results and Conclusion: Levonogestrol containing-IUS is a highly effective treatment of HMB in perimenopausal women. It is a safe, effective, and quality of life after treatment makes it a good alternative to hysterectomy for HMB.
Background Medical abortion up to seven weeks of pregnancy by using a combination of mifepristone and misoprostol with careful follow-up is approved by WHO guidelines. But due to the counter sale of medical termination of pregnancy (MTP) pills, in our country, pregnant women have easy access to use them landing upon serious complications. The present study aims to assess the outcome of self-medicated MTP pills in pregnant women. Method This prospective observational study includes pregnant women who presented to our hospital for medical assistance due to complications after using the counter of MTP pills without medical consultation. Findings of ultra-sonographic and physical examination were noted along with analysis of subsequent management. Results The major complaint at presentation was excessive bleeding (78%). Out of 100 patients, 66% of cases were diagnosed as incomplete abortion, 6% as missed abortion, and 6% as unaffected pregnancy. Ectopic pregnancy was detected in 12% of cases. Sixty patients of incomplete abortion were managed with suction and evacuation and six were supplemented with misoprostol. All patients with ectopic pregnancies were managed surgically. Conclusion The majority of the pregnant women who took MTP pills presented with serious complications in the form of bleeding, incomplete/missed abortion, and ectopic pregnancy. Restriction of the over-the-counter dispensation of abortion pills needs to be strictly implemented and knowledge of women regarding the unfavourable outcome of MTP pill intake without proper consultation needs to be improved.
Objective Hypertriglyceridemia (HTG) in pregnancy causes an increased risk for maternal and fetal complications. But, reports on the impact of HTG in pregnancy on maternal and fetal outcomes are scarce in developing countries. We aim to determine the maternal and neonatal complications of HTG in pregnancy. Materials and methods This prospective observational study was conducted on 150 pregnant women with HTG in the department of obstetrics and gynecology, KIMS, Bhubaneswar, from December 2019 to November 2020. Measurement of triglycerides during the first trimester, second trimester, and delivery was done. Maternal complications and neonatal outcomes in HTG mothers and mothers with normal triglyceride levels were compared. Results Out of 150 HTG cases, hypothyroidism, preeclampsia, acute pancreatitis, and sickle cell crisis occurred in 41 (27.3%), 22 (14.7%), six (4%), and three (2%) cases, respectively. The triglyceridemia (TG) levels raised from 133.7±48.2 mg/dl in the first trimester to 232.8±151.0 mg/dl in the third trimester. There is a significant increase in TG levels at the time of delivery compared to the first and second trimesters (p< .001). Out of 140 neonates, 30 (21.4%) were preterm, eight (5.7%) had intrauterine growth restriction (IUGR), and four (6.06%) were macrosomic. Intrauterine death, preterm, and macrosomia are significantly associated with maternal HTG compared to normal mothers (p < .032). All mortalities were due to acute pancreatitis (6; 4%) among mothers and four intrauterine fetal death. Conclusion There is a steady increase in TG levels in the successive trimesters of pregnancy. Gestational severe hypertriglyceridemia causes life-threatening complications. HTG-induced acute pancreatitis needs to be managed aggressively to prevent maternal death. Neonates of HTG mothers suffer from complications like prematurity, IUGR, and macrosomia.
Background: Knowledge regarding contraceptives and practice of their use or nonuse decide the health outcomes of married women. There appears to be an unmet need of contraceptive use making a gap between the reproductive intentions and women's contraceptive behaviour. This has led to many women being deprived of their needs of contraception as well as exposing them to unnecessary child birth. Aims and Objectives: The aims of this study were (1) to determine the knowledge and practice of various contraceptive methods in married couples attending a tertiary care teaching hospital, (2) to know about their use, nonuse, or discontinuation among them, and (3) to suggest methods to improve their use and making them more safe and effective. Materials and Methods: A cross-sectional observational study was conducted for 6 months. Married women (n = 200) attending the obstetrics and gynecology outpatient department of KIMS hospital Bhubaneswar participated in the study. They were given a questionnaire after obtaining their informed consent. The information from them on sociodemographic variables, awareness, and knowledge was documented, and the practices of their use/nonuse were analyzed. Results: Majority of women were aware of contraceptive usage (87%). The main reason for discontinuing of contraceptives was to get a child (49.2%). Among the nonusers, 29% attributed the reason to apprehension of side effects. Media (64.5%) was the most common source of information. 5% of women used medical termination of pregnancy kit to terminate the pregnancy without knowing the grave consequences of such usage. Conclusion: The knowledge for contraceptives was high, but their usage was low. Hence, there is a need for improving the contraceptive use among married women. The approach to contraception should be designed taking into consideration of the patient's reproductive intentions so that child birth could be a planned process and unwanted pregnancies can be avoided.
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