NRR Hospital

Intrauterine contraceptive devices offer reliable and reversible contraception. However, there are still challenges that persist in their management, particularly regarding deeply embedded PPIUCDs (Post-Partum Intrauterine Contraceptive Devices). We present a case study of a 30-year-old woman who had two caesarean deliveries and sought PPIUCD removal to plan a future pregnancy. On speculum evaluation, the threads of the device were undetectable with no abnormal health symptoms. Subsequent ultrasound analysis confirmed the presence of PPIUCD, positioned obliquely within the uterine cavity. The first removal attempt under aseptic precautions with an IUCD hook was unsuccessful. The second attempt was guided by ultrasound and hysteroscopy, which successfully eliminated the IUCD. The case highlights the intricate challenges in managing PPIUCDs and emphasizes the importance of proactive management strategies. By integrating advanced techniques like hysteroscopy, healthcare providers can navigate these challenges effectively, enhancing patient care and satisfaction. Intrauterine contraceptive devices have become a reliable and convenient method of birth control due to their high effectiveness and reversibility. Long-acting contraceptives provide reliable and lasting protection against unintended pregnancy, making them a popular choice for individuals looking for a hassle-free contraception method. The PPIUCD technique involves implanting an IUCD within 48 hours following either vaginal delivery or caesarean surgery to block sperm survival and prevent endometrial foreign body reactions.[1] The acceptability rate for PPIUCD implantation is 36.25%.[2] The placement of the PPIUCD is preferable since it does not interfere with breastfeeding.[3] The prevalence of modern contraceptives among married women who have reached reproductive age has gradually increased globally, rising from 55.0% in 2000 to 57.1% in 2019.[4] According to the recent India National Family Health Survey, the contraception prevalence rate among currently married women under 15 to 49 increased from 54% in 2015-16 to 67% in 2019-21. Intrauterine devices comprise only 2.1% of all contraceptive techniques used in family planning. However, all government facilities offer free IUCD services.[5] Complications like bleeding, pain, infection, perforation, and expulsion contribute to 20–40% discontinuation rates.[6] Younger women using IUDs are more likely to experience adverse effects than older women.[7] The limited progress was attributed to factors such as the low quality of services offered, restricted access, and misconceptions about techniques held by providers and users. Despite their effectiveness, IUDs can lead to potential complications. One such issue is the occurrence of lost or embedded IUDs, which are rarely observed, with approximately 1-2 cases per 1000 insertions.[8] This case report illustrates the difficulties encountered in removing embedded IUDs and underscores the significance of exploring alternative techniques to manage challenging cases safely and effectively.

Objectives: This study aims to study the neonatal COVID-19 incidence and outcome in District Hospital, Ballari. Materials and Methods: This is a retrospective analytic study of 171 neonates born to COVID-19-positive pregnant women delivered at District Hospital, Ballari, Karnataka, during the period of April 2020–September 2020. Results: The study was conducted among 171 babies delivered to COVID-19-positive pregnant women delivered in District Hospital, Ballari. Out of which, 62 babies were admitted in SNCU for various indications such as respiratory distress syndrome (4), meconium aspiration syndrome (8), other causes of respiratory distress (13), birth asphyxia (8), neonatal jaundice (14), hypoglycemia (1), preterm care (8), and neonatal COVID-19 (1). Out of 171 neonates born to COVID-19-positive mothers, only 7 (4%) neonates were tested positive for reverse transcription-polymerase chain reaction. A total of three babies were symptomatic, among those, two had refusal of feeds and one had respiratory distress and hypernatremic dehydration. Conclusion: In this study, COVID-19-positive neonates had milder manifestation with transmission rate of 4%. All symptomatic babies got cured and discharged successfully with average length of stay for 4 days. Although our conclusions are limited, the findings conclude that neonatal COVID-19 outcome is not as severe as seen in adults.

BACKGROUND:In recent years’ medical management with misoprostol is an effective alternative to surgical evacuation. But there is a dearth of evidence to reveal the effectiveness of the different routes of misoprostol and satisfaction rate among the patients treated with these routes.AIM:This study was conducted to compare the effectiveness and patient’s satisfaction rate of vaginal versus oral misoprostol.METHODS:It was a prospective non-interventional study. One hundred women of having missed abortion confirmed by ultrasonography examination were enrolled in the trial. Fifty-eight subjects were administered 200 mcg of oral and 42 subjects received 200 mcg of vaginal misoprostol every four hours up to four doses. If complete expulsion did not occur 12 hours after the last dose, the surgical evacuation was done.RESULTS:There was no significant statistical difference between the effectiveness of treatment with vaginal (78.57%) and oral misoprostol (79.31%) (p = 0.928). The difference between Patients’ satisfaction at the time of discharge for the vaginal group (64.29%) and oral group (65.52%) was not statistically significant (P = 0.991). There was an increase in patients’ satisfaction for both groups at the follow-up session, but still, the difference was not significant (P = 0.897).CONCLUSION:This study confirms that there is no statistical difference between the effectiveness and patient satisfaction of oral and vaginal misoprostol in the treatment of missed abortion.