Browsing by Author "Mehta, Anushka S."

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    Depot medroxyprogesterone acetate injection as contraceptive method
    (Medip Academy, 2024-08) Patel, Riya R.; Sheth, Paresh N.; Mehta, Anushka S.
    Background: Depot medroxyprogesterone acetate (DMPA) injection is a reversible longer acting contraceptive method. One injection every three months makes compliance better and lesser side effects makes this contraception acceptable.Methods: This is a prospective study done at our institute between July 2021 to September 2023. After prior approvals, each patient of study group had been given Inj. DMPA 150 mg intramuscularly at the time of enrolment. They were given DMPA every 3 months. All participants were followed for efficacy, side effects and continuation rates.Results: Out of 104 participants, 49.05% belonged to 18-25 years of age group, 36.53% were 2nd paras and 41.35% took injections post-delivery. In this study 51.92% patients took >=4 injections where as 45.19% discontinuation rate was found at the end of 1 year. Irregular bleeding seen in 50.96% was the most common side effect. 40.42% of total drop out was due to irregular bleeding. Efficacy of DMPA was found to be 100% in this study.Conclusions: The study concludes that DMPA is a preferable contraceptive method in all the groups of patients for spacing and to avoid unplanned pregnancy. Education and socio-economic factors play key role in acceptance and continuation of DMPA. Menstrual irregularities were found to be most common cause of discontinuation. Use of DMPA has no permanent impact on fertility and it was found to be a safe alternative method with no deleterious effect on mother's milk secretion in lactating participants. It is reversible, non coitus dependent and long acting.
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    Diagnosis and management of cases of ectopic pregnancy in a tertiary care centre: our experience
    (Medip Academy, 2024-05) Mehta, Anushka S.; Patel, Riya R.; Shah, Parav D.
    Background: Ectopic pregnancy is a leading cause of maternal morbidity and mortality. With our study, we aim to highlight the importance of risk factors and effect of clinical presentation on the management modalities of ectopic pregnancy and study changing trends of modern management from radical surgical methods to medical and laparoscopic management of ectopic pregnancies.Methods: This prospective study was undertaken at a tertiary care hospital between May 2021 and May 2022.Results: The most common age group of presentation was 26-30 years. The most common risk factor was history of previous abortion. Amenorrhoea and abdominal pain were the most commonly encountered symptoms in this study. Cervical motion tenderness was significantly associated with ruptured ectopic pregnancy. Conservative medical management with injection methotrexate (Mtx), which was successful in 50% cases. Success rate was 100% for laparoscopic management and 100% for laparotomy in this study. No maternal mortality was observed during the present study.Conclusions: Our hospital being a tertiary centre, had to manage a number of cases as surgical emergencies by laparotomy and not conservatively, as they brought in either diagnosed cases of ruptured ectopic pregnancy, or failure of medical management. It is important that in the face of this diagnostic dilemma, all physicians should be should maintain a high level of suspicion and be sensitive to the fact that in the reproductive age group any woman presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be considered irrespective of the presence or absence of amenorrhea or tubal sterilisation.
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    Placenta previa: risk factors, feto-maternal outcome and complications
    (Medip Academy, 2019-12) Yadava, Pushpa A.; Patel, Riya R.; Mehta, Anushka S.
    Background: Placenta previa is defined as placenta that is implanted somewhere in the lower uterine segment either over or very near the internal cervical os. Placenta previa and coexistent accrete syndromes contribute substantively to maternal and perinatal morbidity and mortality.Methods: All This is a retrospective study of 88 cases of placenta previa, which were admitted under department of obstetrics and gynecology in our institute during July 2017 to June 2019. All patients of placenta previa with gestational age > 28 weeks up to full term were included in the study. All cases were confirmed by ultrasound examination. Outcome measures prevalence of placenta previa, maternal and neonatal outcomes, and case fatality rate.Results: The total number of deliveries performed during the study period was 16330, of them, 88 cases were placenta previa. Thus, the prevalence of PP was 0.53%. Multiparity was one of the etiological factors in 84.09%, whereas previous LSCS was 47.73%, previous H/O D and E was 14.73%, previous H/O placenta previa was 7.95%. Obstetric hysterectomy was done in 7 (7.95%) patients out of 88 patients. 92.04% of patients delivered with cesarean section and 7.95% patients delivered with normal vaginal delivery. 22 (26.50%) babies out of 83 live born were admitted in NICU.Conclusions: Advancing maternal age, multiparity, prior cesarean section, and prior abortions are independent risk factors for placenta previa. Placenta previa remains a risk factor for adverse maternal and perinatal outcome. The detection of placenta previa should encourage a careful evaluation with timely delivery to reduce the associated maternal and perinatal complications. Measures to reduce the primary caesarean section rate should be adopted.