Feasibility of injectable Depot medroxyprogesterone acetate in a semi urban camp setting

Nautiyal, Ruchira; Bijalwan, Rajeev; B, Maithili; Sinha, Latika N.

doi:10.18203/2320-1770.ijrcog20160857

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…The 1‐year continuation rate of 79.9% in the present study was comparable to previously reported rates of 76.0% and 88.3% . The current continuation rate for IUCD use was higher than the rates of 58 and 68% for oral contraceptive pills and injectable contraceptives, respectively . Of note, continuation rates with TCu380Ag were higher than those with TCu380A at all time points assessed despite similar counseling and follow‐up between the two groups.…”

Section: Discussionsupporting

confidence: 82%

A 1‐year comparison of TCu380Ag versus TCu380A intrauterine contraceptive devices in India

Kriplani

Sehgal

Konar

et al. 2019

Intl J Gynecology & Obste

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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.

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Section: Discussionsupporting

confidence: 82%

A 1‐year comparison of TCu380Ag versus TCu380A intrauterine contraceptive devices in India

Kriplani

Sehgal

Konar

et al. 2019

Intl J Gynecology & Obste

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“…The present study provides insights into the demographic characteristics of DMPA users which offers valuable comparisons with existing literature. Notably, a significant proportion of participants fell within the age group of 21-35 years, aligning with similar studies reporting mean ages of 26.5-27 years [18][19][20]. In the context of educational level, the majority of women in our study completed only higher secondary education, as seen in a study by Rajarajeswari et al [21].…”

Section: Discussionsupporting

confidence: 89%

Acceptance, Adherence, and Side Effects of Depot Medroxyprogesterone Acetate: A Prospective Observational Study

Rajaraman,

Vaithilingan,

Selvavinayagam

2024

Cureus

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Introduction In India, one of the world’s most populous and swiftly growing countries, it is crucial to prioritize the utilization of safe and effective contraception, as contraceptive strategies play a pivotal role in bolstering community health. It is widely acknowledged that ensuring appropriate timing and spacing of pregnancies is crucial for the well-being of reproductive, maternal, neonatal, child, and adolescent health. Adoption of reversible or spacing contraceptive methods can significantly enhance women’s health outcomes by reducing the occurrence of undesired, closely timed, and mistimed pregnancies. Consequently, in response to the pressing need for dependable contraception in India, this study seeks to assess the acceptance, adherence, and side effects of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) among its users. Methods This prospective observational study was done at the State Government Taluk Hospital in the Cuddalore District of Tamil Nadu from July 2022 to October 2022. A total of 40 women of reproductive age who opted for DMPA as their contraceptive method and met the inclusion criteria were recruited through a purposive sampling method. A structured questionnaire was used to collect the data. Results The majority of the participants were women aged 21-25 years (n=14; 35%). The participants were predominantly Hindu (n=39; 97.5%), and 35 (87.5%) had completed higher secondary education. All participants (n=40; 100%) resided in rural areas and the majority were homemakers. A significant proportion of the participants had two children (n=21; 52.5%), and all of them received information on DMPA primarily from health personnel. At the initial point of data collection, three-fourths of them took the first dose (n=13; 32.5%) and only a few took more than three doses (n=3; 7.5%). In the third month, the results showed a drop in DMPA use, which indicates a lower adherence particularly linked to side effects like irregular bleeding (n=15; 37.5%) and amenorrhea (n=9; 22.5%). Furthermore, 35 (87.5%) of the women chose DMPA for birth spacing due to its efficacy and convenience, with few initiating it during postpartum (n=4; 10%) and post-abortal (n=1; 2.5%) periods. The reasons for continuing DMPA use included efficacy (n=20; 50%), discreet usage (n=15; 37.5%), and curiosity (n=13; 32.5%). Half of the participants reported no side effects. The study identified associations between DMPA users and the number of living children and occupational status inferring that DMPA contraception is used for spacing births. Conclusion The results of this study imply that the use and adherence to injectable contraceptive DMPA need to be strengthened among rural women. Thus, the study suggests incorporating information, education, and communication strategies, to enhance awareness among rural women about injectable contraceptives.

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“…A study by Rai L et al, Sirisha PSNRS, Nautiyal R et al, the mean age of women was 26.6 years, 25 years and 26.5 years respectively. 10,12,14 In this study, 3.3% were nullipara, primi para in 46.7%, 2 nd para in 36%, 3 rd para in 11.3% and 4 th para in 2.7% and accepted injection depot medroxy-progesterone acetate as a temporary method of contraception. In a study by Nautiyal R et al, 51% patients were primiparas while 49% were multiparas whereas in a study by Rai L et al 2007, 73% per cent of the women were primipara while the remaining 27% were multiparous.…”

Section: Discussionmentioning

confidence: 50%

“…In a study by Nautiyal R et al, 51% patients were primiparas while 49% were multiparas whereas in a study by Rai L et al 2007, 73% per cent of the women were primipara while the remaining 27% were multiparous. 14 In this study, 59.3% of patients in interval period, 18.7% in post-partum period and 22% in post abortal patients. A study by Lavanya Rai et al 2007, 51% of the respondents were post-partum while the rest were either postabortal or interval users.…”

Section: Discussionmentioning

confidence: 52%

Study the acceptance, compliance and efficacy of injection depot medroxy progesterone acetate as contraception: a prospective observational study

Mane

Rokade

2020

Int J Reprod Contracept Obstet Gynecol

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Background: India was the first country in the world to launch a family planning programme, as early as 1952, with the main aim of controlling its population. Depot medroxy progesterone acetate, or DMPA is a progestin-only method of contraception. It is a 3-monthly intramuscular injectable that delivers 150 mg of medroxyprogesterone acetate in microcrystalline suspension form that delays absorption of the hormone after the injection. It provides long acting, effective and reversible contraception. In this study, we evaluated patients in reproductive age group 18-35 years who were willing to use injectable DMPA as a method of contraception to study the acceptance, compliance and efficacy of injection depot medroxyprogesterone acetate as contraception.Methods: It is a prospective observational study carried out at Government medical college Miraj on 150 patients who fulfil the inclusion criteria. The postpartum, interval and postabortal categorisation of patients done and they are councelled about the benefits and side effects and drawbacks of DMPA. Injection is given deep intramuscularly after written informed consent and a DMPA card is given to beneficiary. Follow up date explained and patients are observed for follow up and any evidence of bleeding weight gain or any other side effects of DMPA are noted.Results: The mean age of subjects was 24.48±3.494 years. 2) 3.3% of the patients were nullipara, primi para 46.7%, 36% were second para, 11.3% were third para and 2.7% were fourth par. 3) After 1st injection, 47.3% patients were lost to follow-up i.e., they did not turn up for their second dose of injection. 4) Out of 150 patients who accepted the injection as contraception, only 79 patients turned up for their 2nd injection after 3months, out of which only 37 patients turned up for their 3rd dose of injection after 6 months and only 5 patients turned up for their 3rd injection. Thus showing that the compliance is poor among this study population. 5) At 2nd injection, 39.2% discontinued due to amenorrhea, 10.7% discontinued due to irregular bleeding, 18.5% due to weight gain and 31.6% due undergoing permanent method. 6) No patients who came for follow up reported any pregnancies during the course of injection, therefore the efficacy of injection depot medroxy-progesterone acetate, as a method of contraception is 100% in this study.Conclusions: The DMPA is a good method of long acting reversible method of contraception with good acceptance and efficacy with less compliance.

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Feasibility of injectable Depot medroxyprogesterone acetate in a semi urban camp setting

Cited by 6 publications

References 15 publications

A 1‐year comparison of TCu380Ag versus TCu380A intrauterine contraceptive devices in India

A 1‐year comparison of TCu380Ag versus TCu380A intrauterine contraceptive devices in India

Acceptance, Adherence, and Side Effects of Depot Medroxyprogesterone Acetate: A Prospective Observational Study

Study the acceptance, compliance and efficacy of injection depot medroxy progesterone acetate as contraception: a prospective observational study

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