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A comparative study was made regarding the complications of abdominal and vaginal sterilization operations in order to evaluate the efficacy and safety of the 2 procedures. The cases were selected from outpatient departments and family planning clinics of the Patna Medical College (Patna, India) over the 1974-79 period. A preoperative assessment and investigation were performed in all cases. The operations were performed by modified Pomeroy's technique in 300 cases (Group A) by abdominal route and in 300 cases (Group B) by vaginal route. General anesthesia was administered in all cases. Subsequent follow-up was done at intervals of 6 weeks, 3 months, 6 months, 1 year, and up to 5 years. Follow-up attendance was unsatisfactory, but a comparative evaluation of the complications was done in both groups among patients who came for follow-up. Puerperal sterilization cases were excluded from the series. In Group A 149 sterilizations were done with medical termination of pregnancy (MTP) and the remaining were interval sterilizations. In Group B 148 were sterilizations with MTP and the remaining were interval sterilizations. The age varied between 28-42 years. The majority of the patients were more than 4 para in both groups. Pelvic sepsis was more common with vaginal sterilization operations. Complications were as follows in Group A: pyrexia, 30 cases; pain in abdomen, 75; urinary tract infection, 30; sore throat, cough, 60; stitch induration, 90; and wound disruption, 3. For Group B, complications were as follows: pyrexia, 90; pain in abdomen, 30; urinary tract infection, 75; sore throat, cough, 60; tuboovarian mass, 12; wound infection, 45; and persistent temperature rise, 12. The nature of complaints at follow-up for Group A were: leukorrhea, 30; menorrhagia, 60; irregular bleeding, 30; dysmenorrhea, 12; dyspareunia, 9; loss of libido, 9; and incisional hernia, 1. Complaints at follow-up were as follows for Group B: leukorrhea, 45; menorrhagia, 21; irregular bleeding, 60; dysmenorrhea, 75; dyspareunia, 60; loss of libido, 12; abdominal pain, 12; and stress incontinence, 3. In sum, the sterilization operation by abdominal route was much safer compared to the vaginal route.
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PMID:Complications after abdominal and vaginal sterilization operation. 687 69

During November 1992-November 1994 at Assiut University Hospital in Egypt, 120 of 240 fully lactating women requesting contraception during the second postpartum month chose the nomegestrol acetate contraceptive subdermal implant Uniplant, while the other 120 chose the copper-releasing IUD CuT 380A. This prospective, non-randomized study evaluated the use of Uniplant during lactation. The mothers and their infants were followed-up once a month for 3 months and then every 2 months up to the infants' first birthday. Neither group experienced a pregnancy. Women in the Uniplant group were less likely to have resumed menstruation at 12 months postpartum than those in the IUD group (38% vs. 63%; p 0.001). The 12-month net continuation rates were statistically similar (88.3% for Uniplant users and 92.4% for IUD users). Reasons for IUD discontinuation were infant death (6), lost to follow up (5), irregular bleeding (2), and depression (1). Reasons for Uniplant discontinuation were lost to follow up (4), irregular bleeding (2), moving to a distant residence (2), and infant death (1). The 2 groups were similar in terms of breast feeding episodes, time of weaning, and the cumulative rates of full and partial breast feeding. Health problems (diarrhea, fever, and cough) affected the infants of both groups at similar incidence rates. The infants in both groups had similar weight, weight gain per day, and linear growth. Six of the 7 infant deaths occurred in the Uniplant group. The difference in the infant death rate was not significantly different, however. Gastroenteritis was responsible for 5 infant deaths. Bronchopneumonia and unexplained convulsion claimed the life of 1 infant each. These findings suggest that Uniplant is an acceptable and effective contraceptive method during lactation and has no adverse effect on infant growth and health.
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PMID:The use of nomegestrol acetate subdermal contraceptive implant, uniplant, during lactation. 893 61