Divya, A (2022) Contraceptive Efficacy and Safety of Centchroman with Biweekly cum Weekly Schedule in Postnatal Women in Tertiary Care Hospital: A Prospective study. Masters thesis, Madras Medical College, Chennai.
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Abstract
BACKGROUND: 25% of worlds eligible couples with an unmet need for contraceptive lives in India. Under our national health mission, family planning is now positioned as a critical intervention for improving women’s health,thereby reducing MMR and NMR. ❖ By imparting effective control, we can decrease the colossal MATERNAL MORTALITY RATE by atleast 25 percent. ❖ Eventhough several contraceptive methods have been there throughout the century, the need for a safer alternative to OC pills has been there since the sixties. ❖ After 22 years of extensive research, scientists at the CDRL, LUCKNOW has developed CENCTCHROMAN, the world’s first non steroidal contraceptive agent. The drug was finally approved in 1991. It was marketed as SAHELI and CHOICE 7 in 1992 India has now licensed centchroman in NEHP under the name CHHAYA from April 2016. The contraceptive efficacy of centchroman was is found to be 93% to 100% has evidence by most observational studies. Most common side effects was documented as were menstrual irregularities. Apart from contraceptive benefits of centchroman other steroidal pills the drug has got many non contraceptive benefits like its rolin, AUB, any other malignancies like Endometrial CA ,Head and neck cancer, Pancreatic Cancer and Breast Cancer. AIMS AND OBJECTIVES: The aim of this study was to assess the Effectiveness, Side effects, Compliance, Discontinuation rates, Resumption to fertility after stoppage of drugs and Failure rate. Among the users of Centchroman (Chhaya) in our tertiary center after its introduction in 2016 under National Family planning Programme. 1. To study the Effectiveness of centchroman as a non steroidal oral contraceptive. 2. To study the possible causes of centchroman failure. 3. To study the incidence of other side effects of centchroman. Moreover, there are very few studies and literature available on efficacy of centchroman as contraceptive other than published report from Central Drug Research Institute, LUCKNOW (CDRI). A systemic review demonstrates that despite evidence of effectiveness of centchroman, more research is needed on side effects and mechanism of action. MATERIALS AND METHODS: • For intiation of centchroman the first pill is taken on the 7th week of post natal period and the 2nd pill 3 days later. • This pattern of days is repeated through the 1st three months .Starting from the 4th month, the pill is to be taken once a week on the 1st pill day and should be continued on the weekly schedule regardless of her menstrual cycle • If the pill is missed by 1 or 2 days but lesser than 7 days, the normal schedule should be continued and client need to use a back up method (eg. condoms) till the next period starts. • If the pill is missed by more than 7 days, client needs to start taking it all over again like a new user that is twice a week for 3 months and then once a week. RESULTS: • During the study period 118 patients were screened and administered. • Centchroman for the study of its contraceptive efficacy. Data from the study was analysed in relation to the age at acceptance, parity, obstetric details at the time of acceptance .The salient features are summarized as follows: 1) The age pattern ranged from 20 to 40 years of age with maximum number in the age group of 21-30 yrs of almost 66%. 2) 75 % of patients had one living child, 25 % of patients in the study group had 2 living chil. 3) The maximum no of acceptors were following delivery of almost 87.5% in my study group. 4) All patients in the study group used centchroman for one year except 5 people who dropped from study since they want to conceive. 5) The drug related side effects were very few and included headache, vomiting and nausea. 6) Menstrual complaints were noted in 13% of acceptors. Delayed Menstrual complaints were noted in 7%, menorrhagia in 2% and oligomennorhoea in 4% of cases. 7) Resumption of fertility is prompt within 2 or three menstrual cycles after stoppage of drugs is evident from my study. CONCLUSION: Since Centchroman has 100% contraceptive efficacy with minimal side effects and Resumption of fertility is also proned after stoppage of drugs, Centchroman can be prescribed as an Ideal Postnatal contraception. Robest randomized control trails are required for documenting long time follow up and side effects of the drug for global recommendation as an Ideal contraception.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221916857 |
| Uncontrolled Keywords: | Contraceptive Efficacy, Safety, Centchroman, Biweekly cum Weekly Schedule, Postnatal Women, Tertiary Care Hospital. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Apr 2022 08:56 |
| Last Modified: | 27 Nov 2023 15:24 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19335 |
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