Kanmani Barathi, L (2022) Study of Effectiveness of Depot Medroxy Progesterone Acetate (DMPA) in Postnatal and the Postabortal Period. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: Population explosion is a major issue especially in our country with the second largest population in world next only to china starting the use of contraception in postpartum period is an effective method of increasing the gap between two pregnancies and hence reducing the family size. However, experience shows that contraception in postnatal and postabortal period is a major challenge. several studies have mentioned that DMPA should be available as a first line method to all those who wish to make an informed choice about reversible methods of contraception. Several investigations have been conducted on various metabolic effects of DMPA, but the results are not consistent. Hence, we aim to do this present study, giving DMPA in the postnatal and postabortal period and study its effects, safety, acceptance. AIMS AND OBJECTIVES 1. To study the acceptance, effectiveness, patient compliance of DMPA. 2. To study the incidence of side effects of DMPA. 3. To study the possible causes of DMPA failure. MATERIALS AND METHODS: All eligible women coming to family welfare clinic over the period of one year from April 2020 to March 2021 in the department of family welfare at institute of obstetrics and gynaecology, ISO -KGH, Chennai, Tamilnadu, India. Written and informed consent was taken from the patients who were enrolled in this study. They were given explained well about the benefits and side effects of DMPA. Those who chose DMPA were taken in this study. DMPA 150 mg IM given after explaining them well about how it is better than other methods of contraception in restoring their haemoglobin levels and having no effect on their lactation. All the females were asked to maintain a diary so that they can remember the date of their next appointment. Patients who were non co-operative and unwilling for it were not included in the study. Every time they came for their follow up they were asked general questions like effect of DMPA in their sexual life, menstrual irregularities, weight gain, milk secretion and also about the symptoms to rule out pregnancy to look forward for any failure. RESULTS: A study was conducted among the 100 postabortal women and 100 postpartum women to find the effectiveness of the DMPA in the Institute of Obstetrics and Gynecology, Chennai and the following findings were noted. • In the postnatal group majority of the study participants 54% belongs to the 26-30 years of age followed by 31-35 years of age 25%. • In Postabortal group majority of the study participants 47% belongs to the26-30 years of age followed by 21-25 years of age. • The mean age of the study participants in the postnatal period is 29.66±3.95 whereas in the postabortal period is 24.74±4.41. • There is no statistically significant difference between the mean age of the postabortal group and the postnatal group. • Majority of the study participants in the Postnatal group is multigravida 65% whereas in the postabortal group it is primigravida 58%. • There is a statistical significance present between the parity status of the two groups. • In both the groups majority of the study participants have done with the primary education (Postnatal period-90% and the Postabortal period - 86%). • There is a difference exist between the two group in the education status and it is found to be statistically significance. • In both the groups more than half of the study participants were employed (Postabortal-60% and in the Postnatal -70%) • The difference between the employment status in both the groups is found to be statistically significant. • In the postnatal group 70% belongs to the lower middle class followed by lower class 23%.Similarly 69% belongs to lower middle class in the postabortal group followed by lower class 20%. • Most of the study participants have taken more than 3 injections (Postnatal-52% and in the postabortal-48%) followed by two injections • There is a statistically significant difference in the number of injections taken in both the groups • The compliance to the injection was more in postnatal period 80% whereas in the postabortal period it was 73% • Loss to follow up was most in the Postabortal period 27% followed by the Postnatal period 20% • There is a statistically significant difference observed between the two groups for the compliance of the injection • The reasons for the discontinuation is the side effects (Postnatal group -12, Postabortal-19) followed by the planning for pregnancy (Postnatal group -2, Postabortal-1). • In 1% of population changed contraception is also noticed. • The most common side effect to be noted is the amenorhoea which 67% in postnatal period and 53% in postabortal period. • The second common side effects is weight gain. • The weight gain is notices in 25% in postnatal period and 37% in postabortal period. CONCLUSION: We conclude from our study that DMPA is the,long acting and reversible contraceptive which is effective for the postabortal and the postnatal period. • Other than menstural disturbances no major significant side effects like the mood swings appears to the study partipants. • It is not affecting the sexual life nor it not affects the lactation. • Pregnancy is not noticed while using DMPA among our study participants. • It is the best contraceptive for the lactation mothers as it is not affecting the fetal weight gain or the milk secretion. LIMITATIONS: • Sample size is small in our study. • Side effects like weight gain and amennorhea may make the study participants anxious which can be reduced if we properly giving awareness related to this contraceptive. RECOMMENDATIONS: • Awareness should be created to the people related to the benefits Depot medroxy progesterone acetate compared to other hormonal pills. • Pre use counselling to the study participants before the use may helps the study participants to accept this contraceptive more.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221916867 |
| Uncontrolled Keywords: | Effectiveness, Depot Medroxy Progesterone Acetate (DMPA), Postnatal and the Postabortal Period. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Apr 2022 08:38 |
| Last Modified: | 27 Nov 2023 15:58 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19328 |
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