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Bharti S, Sharma M, Malik N, Myes D, Marwaha P. Primary Ovarian Pregnancy: A Case Report With a Review of the Literature. Cureus 2024; 16:e56688. [PMID: 38646339 PMCID: PMC11032508 DOI: 10.7759/cureus.56688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Ectopic pregnancy (EP) constitutes 1%-2% of all pregnancies and is one of the leading causes of maternal morbidity and mortality. The most common site of ectopic pregnancy is the ampulla. Ectopic ovarian pregnancy (EOP) is one of the rare events, with an incidence of 0.5%-3% of all pregnancies. The incidence is higher in intrauterine device users or assisted reproductive techniques. The precise aetiology and pathogenesis of EOP remain elusive. Clinically, EOP mirrors the presentation of tubal pregnancy or a ruptured luteal cyst, often leading to life-threatening hypovolemic shock. Transvaginal sonography is the primary diagnostic tool. Still pinpointing the exact location early on poses challenges, and it's usually misinterpreted as a tubo-ovarian mass, hemorrhagic cyst, or luteal cyst. Furthermore, while a suboptimal rise in serum beta-human chorionic gonadotropin (β-hCG) levels may indicate pregnancy, it doesn't definitively confirm EOP. Only histopathological examination offers a conclusive diagnosis. This paper discusses an EOP case in a young woman who experienced five months of amenorrhea and exhibited no traditional risk factors, underscoring the significant challenges inherent in preoperative diagnosis.
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Affiliation(s)
- Sushma Bharti
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Manupriya Sharma
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Nisha Malik
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Deychen Myes
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
| | - Poojan Marwaha
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bilaspur, Bilaspur, IND
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Mittal S, Gupta V, Saxena N, Lata K. Patient Perspectives on Contraceptive use in North India: A Case for Increased Contraceptive Counseling by Providers. J Obstet Gynaecol India 2023; 73:512-521. [PMID: 38205116 PMCID: PMC10774318 DOI: 10.1007/s13224-023-01781-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 05/28/2023] [Indexed: 01/12/2024] Open
Abstract
Background Given the underutilization of contraception in India, this study was undertaken to gauge cisgender female clients' knowledge of, attitudes toward, and barriers to contraceptive usage in North India. Methodology The present study was done at a tertiary care Institute in North India, where 209 structured interviews were conducted with cisgender female patients attending the outpatient department. One-way chi-square tests for independence, Kruskal-Wallis test, and Wilcoxon test were applied to quantitative data. Themes from qualitative questions were coded and analyzed. Results Differences in awareness among contraceptives were found to be highly statistically significant (H (9) = 1022.3, p < 2.2 e-16). Friends or colleagues comprised the predominant information source for most contraceptive methods. Participants' contraceptive usage was low, with 27.27% stating no prior use and 47.47% indicating occasional use (X2 (3, N = 198) = 66.121, p < 2.89 e-14). Lack of perceived need, concern for side effects, fear and desire for children were top reasons for non-use of contraceptive methods. Majority of the participants (79.45%) expressed comfort speaking with their spouse about contraception, 47.18% with a medical provider, 32.82% with friends, 15.38% with family, 2.05% with a health educator, and 3.59% with no one. Participants indicated little prior contraceptive counseling experience. Conclusion Our study shows differential levels of awareness, usage, and barriers on contraceptive methods among participants. Results also suggest the importance of spouses and friends in clients' contraceptive decision-making process and their limited counseling experience with health care providers.
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Affiliation(s)
- Sneha Mittal
- Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand India
- Present Address: University of Tennessee Health Science Center College of Medicine, Memphis, TN USA
| | - Vineeta Gupta
- Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand India
| | - Namrata Saxena
- Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand India
| | - Kirti Lata
- Department of Obstetrics and Gynaecology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand India
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Mukherjee S, Swain D. Barriers and Acceptance of Intrauterine Contraceptive Devices (IUCD) Among Married Women of Reproductive Age in Odisha, India. Cureus 2023; 15:e40919. [PMID: 37496531 PMCID: PMC10367123 DOI: 10.7759/cureus.40919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2023] [Indexed: 07/28/2023] Open
Abstract
INTRODUCTION The Copper-T (Cu T-380 A), an intrauterine contraceptive device (IUCD), is widely available and is a highly effective, safe, long-term, and reversible method of contraception. Despite this fact, there is low utilization of IUCDs in India. Hence, this study focused on determining the rate of acceptability of IUCDs, identifying barriers to acceptance of IUCDs, and finding out the cause of IUCD discontinuation. METHODS A hospital-based cross-sectional study was conducted among 720 married women in the Khordha district, Odisha, India, via a questionnaire and a structured interview schedule. A systematic random sampling method was applied to select the participants. A multivariate logistic regression test was used to determine the factors associated with the acceptance of IUCDs. RESULTS This study revealed that only 20.97% of the potential users were currently using IUCDs, 73.75% had never used n IUCD as a contraceptive, and 20.1% of women had discontinued it. Multiple socio-demographic, obstetrical, and family planning behaviours and a lack of awareness were identified to be linked to IUCD acceptability. Fear of adverse effects, family members' objections, availability of other modern contraceptive methods, husband's disagreement, and lack of awareness about the benefits of IUCDs were the most stated reasons for refusal of IUCDs. The most common reason for discontinuing an IUCD was the desire for another child. CONCLUSION The rate of acceptability of IUCDs was quite low in Odisha as compared to other parts of India and, therefore, this study recommends imparting counselling on effective methods of family planning to increase the acceptance of IUCD use.
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Affiliation(s)
- Sangita Mukherjee
- College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Dharitri Swain
- Obstetrics and Gynaecological Nursing, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Harris DM, Dam A, Morrison K, Mann C, Jackson A, Bledsoe SM, Rowan A, Longfield K. Barriers and Enablers Influencing Women's Adoption and Continuation of Vaginally Inserted Contraceptive Methods: A Literature Review. Stud Fam Plann 2022; 53:455-490. [PMID: 35922382 PMCID: PMC9545114 DOI: 10.1111/sifp.12209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Most vaginally inserted methods have limited availability and use despite offering characteristics that align with many women's stated preferences (e.g., nonhormonal and/or on demand). The objective of this review was to identify enablers and barriers to women's adoption and continuation of vaginally inserted contraceptive methods in low- and middle-income countries (LMICs). We searched three databases (PubMed, Embase, and Web of Science) and 18 websites using keywords related to five vaginally inserted contraceptive methods (diaphragm, vaginal ring, female condom, copper intrauterine device [IUD], hormonal IUD) and terms associated with their adoption and continuation. Searches were limited to resources published between January 2010 and September 2020. Studies eligible for inclusion in our review presented results on women's use and perspectives on the enablers and barriers to adoption and continuation of the vaginally inserted contraceptive methods of interest in LMICs. Relevant studies among women's partners were also included, but not those of providers or other stakeholders. Data were coded, analyzed, and disaggregated according to a framework grounded in family planning (FP) literature and behavioral theories common to FP research and program implementation. Our initial search yielded 13,848 results, with 182 studies ultimately included in the analysis. Across methods, we found common enablers for method adoption, including quality contraceptive counseling as well as alignment between a woman's preferences and a method's duration of use and side effect profile. Common barriers included a lack of familiarity with the methods and product cost. Notably, vaginal insertion was not a major barrier to adoption in the literature reviewed. Vaginally inserted methods of contraception have the potential to fill a gap in method offerings and expand choice. Programmatic actions should address key barriers and enable voluntary use.
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Affiliation(s)
- Danielle M Harris
- Danielle M. Harris is Senior Program Manager, Kate Morrison is Program Manager, and Shannon Bledsoe is Executive Director, Catalyst Global, Carlsbad, CA, United States
| | - Anita Dam
- Anita Dam is Technical Advisor for the Introduction & Access of HIV Prevention Technologies, United States Agency for International Development (USAID), Global Health Technical Professionals Program, Washington, DC, USA
| | - Kate Morrison
- Danielle M. Harris is Senior Program Manager, Kate Morrison is Program Manager, and Shannon Bledsoe is Executive Director, Catalyst Global, Carlsbad, CA, United States
| | - Chastain Mann
- Chastain Mann is Chief Executive Officer, Mann Global Health, Columbus, North Carolina, USA
| | - Ashley Jackson
- Ashley Jackson is Team Lead for Sexual & Reproductive Health, Primary Health Care Program, PATH, Seattle, Washington, USA
| | - Shannon M Bledsoe
- Danielle M. Harris is Senior Program Manager, Kate Morrison is Program Manager, and Shannon Bledsoe is Executive Director, Catalyst Global, Carlsbad, CA, United States
| | - Andrea Rowan
- Andrea Rowan is Independent Consultant and Kim Longfield is Founder and Principal, Databoom, Washington, DC, USA
| | - Kim Longfield
- Andrea Rowan is Independent Consultant and Kim Longfield is Founder and Principal, Databoom, Washington, DC, USA
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Al-Husban N, Kaadan D, Foudeh J, Ghazi T, Sijari Y, Maaita M. Factors affecting the use of long term and permanent contraceptive methods: a Facebook-focused cross-sectional study. BMC Womens Health 2022; 22:204. [PMID: 35655199 PMCID: PMC9160863 DOI: 10.1186/s12905-022-01784-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction In the Muslim world, the use and acceptance of long-term and permanent contraceptives were limited. Our aim was to investigate those limiting factors so we can help making these methods widely available and acceptable to the society.
Methods and data analysis There were 1365 women from Facebook groups in the period 08/10/2020–8/11/2020. Participants were married women, living in Jordan. This was a cross-sectional study. Statistical Package for Social Sciences (SPSS), version 16, software was used for statistical analysis (Chicago, Illinois, USA). Results Among participants, 22.3% had never used any contraceptives. Non-hormonal IUCD was the most commonly used method. There was a statistically significant association between the use of hormonal IUCD and women's age, marriage duration, education and number of children (p < 0.0001). Tubal ligation was adopted by only 44 (3.22%) participants. 19.68% of participants declined tubal ligation merely due to religious issues. Women who completed only high school level of education underwent tubal ligation significantly more than those with university (Bachelor) and post-university (Master or PhD) degrees (p < 0.0001 and 0.026, respectively). Only 1.83% of women's partners underwent vasectomy, the majority of these vasectomies (72.0%) were done because of the need for lifelong contraception. Around 17% of women's partners had poor knowledge about vasectomy. Further, women's employment status (housewives or full-time employees) was found to be the only variable that affected acceptance of vasectomy (p = 0.0047). Conclusions Women endured a heavy burden of contraception. Cultural and religious taboos influenced tubal ligation. Vasectomy was still very rarely adopted by men due to the lack of knowledge about the procedure. Our results raised the need for further dissemination of contraception knowledge and counselling through the primary care and maternity centers, mosques and media in official, comprehensive and integrated programs. Future research is needed in the field of permanent contraceptive methods.
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Affiliation(s)
- Naser Al-Husban
- School of Medicine, The University of Jordan, P O Box 2194, Amman, 11941, Jordan.
| | - Dalia Kaadan
- School of Medicine, The University of Jordan, P O Box 2194, Amman, 11941, Jordan
| | - Jude Foudeh
- School of Medicine, The University of Jordan, P O Box 2194, Amman, 11941, Jordan
| | - Tara Ghazi
- School of Medicine, The University of Jordan, P O Box 2194, Amman, 11941, Jordan
| | - Yumen Sijari
- School of Medicine, The University of Jordan, P O Box 2194, Amman, 11941, Jordan
| | - Maher Maaita
- Obstetrics and Gynecology Department, The Royal Medical Services, Amman, Jordan
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Determinants of Postpartum Intrauterine Contraceptive Device Uptake among Women Delivering in Public Hospitals of South Gondar Zone, Northwest Ethiopia, 2019: An Unmatched Case-Control Study. Obstet Gynecol Int 2021; 2021:1757401. [PMID: 33688350 PMCID: PMC7920734 DOI: 10.1155/2021/1757401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 01/31/2021] [Accepted: 02/06/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Integrated use of postpartum intrauterine contraceptive devices with delivery service during the immediate postpartum period is ideal for both women and health-care providers. However, utilization of intrauterine contraceptive devices during the postpartum period was rare and in Ethiopia, with information regarding uptake of postpartum intrauterine contraceptive devices limited. Objective Identify determinants of postpartum intrauterine contraceptive devices uptake among women delivering in public hospitals of South Gondar zone, Northwest Ethiopia, 2019. Methods An unmatched case-control study was conducted in public hospitals of South Gondar, Ethiopia, from August 1, 2019, to November 10, 2019. A total of 140 cases and 280 controls have actively participated in the study. Five hospitals were selected by simple random sampling. Cases were selected consecutively, whereas two controls for each case were recruited by the lottery method. Pretested questionnaires were used to collect data and it was entered into Epidata version 4.4.2. Logistic regression analysis was used to identify variables associated with the use of outcome and adjusted odds ratio with a 95% confidence interval was used to determine the association between independent and outcome variables. Results Completing secondary education (AOR = 4.5, 95%CI 2.3-8.85), having a total number of children of 3-4 (AOR = 3.6, 95%CI 1.25-10.2), having ≥ 5 (AOR = 4.7, 95%CI 1.5-15.3), attending 3 antenatal care (AOR = 2.8, 95%CI 1.44-5.6), ever hearing about postpartum IUCD (AOR = 6.6, 95%CI 2.7-16.1), and having counseling from health-care provider about a postpartum intrauterine contraceptive device (AOR = 6.2, 95%CI 2.99-12.8) were significantly associated with uptake of the postpartum intrauterine contraceptive. Conclusion and Recommendation. Completing secondary education, having 3-4 and ≥5 children, attending three antenatal care, ever hearing about postpartum IUCD, and having counseling from health-care providers about the postpartum intrauterine contraceptive device among women were significantly associated with uptake of an intrauterine contraceptive device after birth. Therefore, it is better to advise women to strictly follow their antenatal care, access to information, and provide counseling.
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