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Objectives: This trial examined the effectiveness of intrauterine alginate carboxymethylcellulose hyaluronic acid–(ACH) gel application after vacuum aspiration as a treatment in first-trimester abo...

Congenital Mullerian duct anomaly is a common cause of infertility, preterm labor, first trimester abortion.

Pregnancy-related ocular diseases develop mostly in the third trimester of pregnancy. Here, we describe a case of a pregnant woman with a choroidal mass that caused a serous retinal detachment during the first trimester of pregnancy. The patient's condition resolved spontaneously after an abortion.

Background: Spontaneous abortion also known as miscarriage is one of the most common conditions encountered by the gynecologists and obstetricians. The women who had spontaneous miscarriage have traditionally undergone surgical uterine evacuation of retained products of conception. In recent years more and more patients are evaluated with more and more refined diagnostic techniques and therapeutic interventions. In our center too, it is a routine practice to submit tissues obtained by uterine evacuation to the histopathology department, and to confirm intrauterine fetal tissue. Methods: The present retrospective study was done for a period of one year in the department of Pathology, Gujarat Adani institute of medical sciences, G. K General Hospital, Bhuj. Total 62 samples of uterine evacuation products were evaluated. Along with their clinico-pathological correlation the histopathological spectrum of the lesions were also studied and the necessary statistical analysis was done. Result: The most common clinical diagnosis was retained product of conception (34%), followed by hydatidiform mole (24%). The most common histological finding was presence of chorionic villi (55%), followed by presence hydatidiform mole (24%). Clinico-pathological correlation was found in (79%). Conclusion: The present study was to highlight the importance of histopathological evaluation of the uterine evacuation products. Our study strongly recommends the histopathological examination of all uterine evacuation products as it aids in timely management of the patients.

Access to first trimester abortions has increased significantly in the past few decades in low and middle-income countries. Manual vacuum aspiration is now standard of care for procedural abortion and postabortion care. Medication abortion has shifted abortions to being performed earlier in pregnancy and is becoming more widely available with new service delivery strategies to broaden access. Widespread availability of misoprostol has made abortions induced outside of the formal medical sector overall safer. In both legally restrictive and supportive environments, there is increased interested in self-managed abortions as part of a shift towards demedicalizing abortion through task-sharing.

Introduction: The aim was to study the expression of p57(KIP2) immunohistochemical marker in first trimester abortion specimens of molar and non-molar pregnancies. Materials and Methods: The study design was a cross-sectional study conducted in the Department of Pathology of a teritiary health care centre in South India. 100 cases of first trimester abortion specimens of molar and non-molar pregnancies were studied.The study duration was two years. The IHC used is p57(KIP2) which is a mouse derived monoclonal antibody and its expression in decidual and villous tissue of abortion specimens were observed. Result: Of 100 cases of first trimester abortion specimens 25 cases were complete mole, 17 were partial mole and rest 58 cases were normal abortions. p57 gene is paternally imprinted and maternally expressed, and the presence of its protein product serves as an useful adjuvant marker for the nuclear maternal genome. Regarding the expression of p57(KIP2) immunomarker in partial mole(PM) diagnosed previously by H&E 88% expressed positive results. These findings were highly statistically significant. The results of p57 IHC marker expression in cases of complete mole diagnosed previously by H&E, 96% expressed negative results which confirmed the complete mole diagnosis. Conclusion: The study of p57 immunohistochemistry in abortion specimens has proved to be an ancillary diagnostic tool in the diagnosis of complete mole. The sensitivity and specificity of p57 were very high in diagnosing complete mole from its close mimic partial mole in early first trimester abortions. The sensitivity and specificity were 96% and 88% respectively. Keywords: Hydatidiform mole (HM), Immunohistochemistry (IHC), Complete mole (CM), Partial mole (PM). Introduction Gestational trophoblastic disease are a group of benign and malignant entities, where the hydatidiform mole is the most common, and can be divided into complete hydatidiform mole and partial hyda

Placenta accreta is a potentially life-threatening condition that may complicate a first-trimester abortion in rare occasions, and it can be difficult to recognize. We reviewed the literature in PubMed-indexed English journals through August 2018 for first-trimester postabortal placenta accreta, after which 19 articles and 23 case reports were included. The risk factors for the development of abnormal placentation are previous cesarean section (87%), previous history of uterine curettage (43.5%), and previous history of surgical evacuation of a retained placenta (4.3%). Ten patients (43.5%) had an advanced age (≧35 years). Most patients clinically presented with vaginal bleeding, ranging from intermittent or irregular bleeding, persistent bleeding, and profuse or massive bleeding. The onset of symptoms might be during the intra- or immediate postoperative period. Some patients had delayed symptoms 1 week to 2 years postoperatively. Conservative management may be attempted as the primary rescue, including uterine artery embolization (UAE), transcatheter arterial chemoembolization (TACE) with dactinomycin, and laparoscopic hysterotomy with placental tissue removal. However, most reports in the literature suggested either abdominal or laparoscopic hysterectomy as the definitive treatment for first-trimester postabortal placenta accreta. High index of clinical suspicion with anticipation of placenta accreta in early pregnancy is highly essential for timely diagnosis, providing the physician better opportunities to promptly manage this emergent condition and improve outcomes. Keywords: First-trimester abortion, First-trimester pregnancy, Placenta accreta

Objective To investigate if women desire talking to a counselor or physician about contraception when seeking first-trimester medical or surgical abortion. Study design We conducted a cross-sectional study by distributing self-administered anonymous surveys to women at three clinics in Sacramento, California; Chicago, Illinois; and Cleveland, Ohio, from October 2014 to February 2015. Participants completed surveys after registration and before any in-office counseling. We asked whether women want to discuss contraception, specific topics they want to discuss, reasons why they may not want to talk about contraception and whether they want to receive contraception services as part of their abortion care. We conducted regression analyses to assess associations between patient characteristics and the desire for counseling. Results Among 3041 eligible women, 1959 (64.4%) completed surveys. Overall, 1208 (61.7%) did not want to discuss contraception prior to having an abortion, primarily citing that they already know which method they want. We found no association between the desire to discuss contraception and age, race, planned abortion method, clinic site and number of unplanned pregnancies. Among those who desired to talk about contraception, subjects preferred to discuss which contraceptive methods are easier to use and more effective as compared to previously used methods. Regardless of their desire for a discussion about contraception, 1386 (70.8%) of subjects wanted to leave the clinic with a specific method, including a long-acting reversible method [intrauterine device or implant (190, 13.7%)] or other hormonal method [pills, patch, ring or injectable (680, 49.1%)]. Conclusions The majority of women seeking first-trimester abortion do not come to the clinic wanting to discuss contraception, most commonly because they have a preferred method in mind. Implications Providers should ask women presenting for abortion if they want to discuss contraception and not assume that they need or desire such information. Focused discussions, starting with the preferred method if known, may better satisfy women's preferences. Providers should account for such desires when allocating resources for contraception services during abortion care.

Background: Managing of abortion is an important subject in gynecology. Millions of patients had sufferedfrom spontaneous abortions that occur per year.Objectives: The aim of this study was to compare the effect of misoprostol alone and misoprostol withletrozole in the induction of abortion in the first trimester of pregnancy.Patients and Methods: In a single –blind clinical trial ,128 female applicants for legal abortion within thefirst trimester of pregnancy that referred to AL-Batool hospital , were divided in to two groups: intervention(misoprostol with letrozole) and control groups (misoprostol alone). The complete abortion, drug-inducedside effects of misoprostol and letazole were noted and evaluated.Results: The complete abortion rate was93.2% in intervention group and in68.7% in the control group(misoprostol) only, which was significantly higher in intervention group (p = 0.001).Abdominal pain in the intervention group is also significantly lower than that of the control group (p =0.013). Intervention group also had significantly lower duration of bleeding rather than control group (p =0.006).Conclusions: Based on our results, pretreatment with letrozole plus Misoprostol was more effective forprompting abortion in the first trimester of pregnancy without increasing side effect compared to misoprostolalone.

Distinction of hydatidiform moles (HM) from non-molar (NM) specimens and subclassification of HM as complete hydatidiform mole (CHM) versus partial hydatidiform mole (PHM) are important for clinical practice and investigational studies. The issue of diagnostic reproducibility is still unsolved, the lack of diagnostic accuracy based on morphology is substantial with an important interobserver variability, even between experienced gynecologic pathologists. Many ancillary techniques have been investigated in the last years to refine HM diagnosis. p57 (a paternally imprinted, maternally expressed gene) immunohistochemistry, based on the unique genetics of CHM (purely androgenetic), PHM (diandric triploid), and NM specimens (biparental, with allelic balance) can identify CHMs, which lack p57 expression because of a lack of maternal DNA. However, although its role in HM diagnosis is pivotal, it does not allow the distinction of PHM from NM specimens, both of which express p57 due to the presence of maternal DNA. Molecular genotyping, which compares villous and decidual DNA patterns to determine the parental source and ratios of polymorphic alleles, distinguishes purely androgenetic CHM from diandric triploid PHM, and both of these from NM specimens. Beyond the claim of establishing a "diagnostic truth", exceptions and peculiar genetic scenarios in the origin of rare CHM and PHM should be kept in mind when approaching any ancillary technique. An algorithmic approach, even in settings with limited resources, can help the pathologists in the diagnostic dilemma of diagnosis of first trimester abortions.

This is a retrospective cohort study reporting on complications of 170,000 first-trimester abortions performed at 3 free-standing Planned Parenthood clinics in New York City from 1971 to 1987. There were no reported deaths. The overall rate of major complications was 0.71 per 1000 procedures, and the overall rate of minor complications was 8.46 per 1000 procedures. The complication rates were similar for patients undergoing general and local anesthesia. More recent studies on the safety of first-trimester abortion, which also included women with chronic medical conditions, have reconfirmed Hakim-Elahi and colleagues’ original findings. Given its observational design, the study findings have limitations due to bias. However, the study is unique in its scope given the large number of patients treated with a standardized protocol over an extensive period of time. The overwhelming evidence on the safety of abortion care in outpatient clinics has important access and policy implications.

Objective To review the relevant literature on abortion and summarize interviews with key stakeholders to assess the role of midwives in the evolution of abortion‐related care in Tunisia. Methods Interviews with eight stakeholders from different organizations based on a guide developed for the study, focusing on policies, strategies used for implementation, capacities used for expansion, user opinions and experience, obstacles and facilitators, and control and evaluation. Results Task‐sharing for midwifes was encouraged in the family planning program from the beginning and when medical abortion was introduced. It allows midwifes to contribute widely, develop good skills and performance for several tasks, and helps reduce regional disparities in human resource allocation. Success and safety of home use of medical abortion confirms the ability of women to manage their own abortion. Yet, obstacles to accessing abortion still exist for several reasons. Conclusion This study, based on interviews with personnel with significant experience and solid knowledge of sexual and reproductive health services, allowed us to consider proposals for a future strategy to integrate task‐sharing into abortion care and address the barriers to legal and safe abortion access for all women in Tunisia., Synopsis Task‐sharing of abortion care with midwives has a positive impact on quality of services and addresses barriers to accessing abortion in Tunisia.

Introduction Serious complications associated with first-trimester abortions are rare. The US mortality rate for these procedures is 0.7 per 100,000, primarily due to infection and hemorrhage. While complications are unlikely to arise during training, residents must be prepared to manage them in practice. To address this, we developed a 2-hour simulation-based abortion complication curriculum for OB/GYN resident learners. Methods OB/GYN residents participated in three sessions: a case-based didactic reviewing institutional aspiration abortion practice and preop preparation; an in-vivo aspiration abortion hemorrhage simulation; and an interdepartmental postabortal sepsis simulation. Participants completed surveys before and after their participation that evaluated clinical knowledge, and self-rated competence in, and preparedness for, managing first-trimester abortion complications. Results Resident learners (N = 26) represented all four classes of OB/GYN residents. Residents initially showed stronger clinical knowledge in managing postabortal hemorrhage than sepsis (90% vs. 62%, p < .001). Clinical knowledge improved following the sepsis simulation (62% to 91%, p < .001), and remained strong but unchanged after the hemorrhage simulation (90% to 87%, p = .3). Resident self-assessments of competence and preparedness were significantly improved after both the hemorrhage (p = .006) and sepsis (p = .002) simulations. Learners reported that the simulation increased their level of comfort in managing these complications in their future practice. Discussion Postabortal hemorrhage and sepsis simulations increased OB/GYN residents' knowledge, comfort, and preparedness for managing rare complications of first-trimester abortions. In-vivo simulation and interdepartmental collaboration were novel aspects of these simulations that may facilitate increased preparedness and management skills.

INTRODUCTION: This study was conducted to analyze the medical and surgical methods of first trimester of pregnancy. MATERIAL AND METHODS: A hospital based retrospective study done at Lumbini Zonal Hospital, Butwal over the period of one year, where all the women who had first trimester abortion services were analyzed. Age, parity, education status, failure rates and post abortion contraception were analyzed.RESULTS: There were total of 478 women who had abortion services, of which 244 women had medical method of abortion. Among them 4.89% were teenagers and 11.29% were primigravida and 6.9% were uneducated. The failure rate for medical method was 9% and for surgical method was 1.7%. Most women at their post abortion period asked for condoms, followed by DMPA, IUD and OCP as a method of contraception.CONCLUSION: Failure rate of medical method was high and acceptance of long acting post abortion contraception was low.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, page: 1-5

Introduction Balancing the need to provide individual support for patients and the need for an efficient clinic can be challenging in the abortion setting. This study explores physician, staff, and specially trained abortion doula perspectives on doula support, one approach to patient support. Methods We conducted separate focus groups with physicians, staff members, and doulas from a high-volume, first-trimester aspiration abortion clinic with a newly established volunteer abortion doula program. Focus groups explored 1) abortion doula training, 2) program implementation, 3) program benefits, and 4) opportunities for improvement. Interviews were transcribed and computer-assisted content analysis was performed; salient findings are presented. Results Five physicians, 5 staff members, and 4 abortion doulas participated in separate focus group discussions. Doulas drew on both their prior personal skills and experiences in addition to their abortion doula training to provide women with support at the time of abortion. Having doulas in the clinic to assist with women's emotional needs allowed physicians and staff to focus on technical aspects of the procedure. In turn, both physicians and staff believed that introducing doulas resulted in more patient-centered care. Although staff did not experience challenges to integrating doulas, physicians and doulas experienced initial challenges in incorporating doula support into the clinical flow. Staff and doulas reported exchanging skills and techniques that they subsequently used in their interactions with patients. Discussion Physicians, clinic staff, and doulas perceive abortion doula support as an approach to provide more patient-centered care in a high-volume aspiration abortion clinic.

Objetivo. Evaluar la eficacia del manejo con misoprostol al emplear el esquema de la Federación Internacional de Ginecología y Obstetricia (FIGO) 2017 para el abordaje de abortos de primer trimestre. Métodos. Estudio transversal realizado entre marzo y septiembre 2018, que incluyó 76 pacientes con diagnóstico de aborto espontáneo en el primer trimestre de gestación y que tuvieron manejo de acuerdo al esquema recomendado por FIGO 2017. Resultados. Las principales indicaciones para la inclusión de las 76 pacientes fueron aborto diferido 57,9%, aborto incompleto 25% y embarazo anembrionado 17,1%. La inducción con misoprostol siguió las indicaciones de FIGO 2017 para el manejo del aborto del primer trimestre. El efecto adverso más frecuente fue el sangrado vaginal asociado a dolor pélvico en 72,3% de las pacientes. Se logró la evacuación uterina completa en 98,6% de los casos. Conclusión. El manejo médico del aborto del primer trimestre de gestación con el uso del misoprostol de acuerdo al esquema FIGO 2017 ofreció una opción terapéutica altamente segura y costo-efectiva.

Background : Approximately 15% of all clinically recognized pregnancies end in spontaneous abortions. Chromosomal disorders are responsible for 50% of the spontaneous abortions. Most commonly it occurs in the first trimester of pregnancy. Aim : To study the cytogenetic analysis of chorion villous tissue in 50 cases of abortion in age groups of 19-40 years. Material and Methods : Cytogenetic analysis was performed by implementing standard protocol of planting, harvesting, banding and screening. The karyotypes were prepared and observed under microscope. Statistical analysis was done by calculating the percentage of abnormal abortions in relation to maternal age. Results : It was observed that maximum abortion took place between 25-34 years of maternal age. The rate of abortion with trisomy was maximum followed by polyploidy and monosomy. It was seen that rate of abortion with monosomy decreases with increase in maternal age. Contrary to this trisomy increased with increase in maternal age. Conclusion : Cytogenetic study revealed that the rate of trisomie abortions increased with the increase in maternal age.

To evaluate the effect of solely intrauterine insemination on perinatal outcomes.A total of 3830 OI/IUI cycles between January 2007 and December 2012 were included in the study. Three hundred and fifty-eight pregnancies following intrauterine insemination were encountered during the study period. Data from 246 pregnancies conceived through OI/IUI treatment were available. A total of 438 singletons with no maternal risk constituted the control group. The two groups were compared according to perinatal outcomes.There was a statistically significant difference between the groups in first trimester abortion and intrauterine demise. At least one or more perinatal adverse outcomes occurred in study and control groups with the rates of 38.4% and 18.5%, respectively. There were significant differences in preterm delivery rate and oligohydramnios between the groups. There were also significant differences in the rate of neonates with a birth weight 2500 g and NICU.In general, women's health perspective, to have a pregnancy is the main target in infertility work-ups, but physicians should be aware of the risks and couples should be counseled that pregnancies after OI/IUI treatment even if singleton carries a risk of adverse perinatal outcome for both the mother and baby.

Objectives: In Slovenia, first-trimester abortion is performed at the woman’s request, either surgically under general anaesthesia or medically with mifepristone and misoprostol, in a publi...

Objective: To compare the effectiveness and tolerability of misoprostol as a cervical ripening agent in first trimester abortion through sublingual and vaginal routes of administration.Material and Methods: This study was carried out in the department of Obst. & Gynae Teerthanker Mahaveer Medical College and Research Centre (TMMC&RC). A total of 120 patients were included in the study. They were divided in two groups Group A – 60 patients – sublingual Group B – 60 patients – vaginal The drug was administered 3-4 hours before suction and evacuation by sublingual and vaginal routes. Efficacy was assessed on the basis of time taken for ripening, dilatation achieved, duration of the procedure, intraoperative blood loss and pain. The patient‘s tolerability was noted on the basis of side effects.Results: The mean time taken for cervical ripening was more in the sublingual group as compared to the vaginal ( P

Abortus merupakan pengeluaran hasil konsepsi sebelum waktunya. Abortus dapat disebabkan karena pengetahuan ibu yang kurang. Penyebab AKI yang paling sering adalah perdarahan. Seperti yang telah diketahui sebelumnya bahwa perdarahan merupakan komplikasi dari terjadinya abortus. Ada banyak masalah kesehatan wanita khususnya pada kehamilan yang melatarbelakangi masalah atau komplikasi kehamilan serta menimbulkan kematian ibu, salah satunya adalah kejadian abortus. Data dari RSUD Arifin Achmad provinsi Riau kasus abortus tahun 2011 mencapai 94 orang ibu hamil, tahun 2012 kasus abortus menurun menjadi 90 kasus. Kemudian pada tahun 2013 sebanyak 109 orang. Tujuan penelitian ini adalah untuk mengetahui hubungan pengetahuan ibu hamil trimester Idengan kejadian abortus di RSUD Arifin Achmad Pekanbaru Tahun 2015. Metode penelitian ini menggunakan jenis penelitian analitik kuantitatif dan desain cross sectional. Penelitian ini diadakan di RSUD Arifin Achmad Provinsi Riau pada 4 April hingga 4 Mei tahun 2015. Populasi dalam penelitian ini adalah seluruh ibu hamil trimester I yang datang ke RSUD Arifin Achmad dan sampel diperoleh sebanyak 34 responden, dengan tekhnik sampling yaitu secara accidental sampling. Pengambilan data menggunakan data primer dengan menggunakan kuesioner, pengolahan data dilakukan dengan cara univariat dan bivariat. Hasil penelitian diperoleh mayoritas responden memiliki pengetahuan kurang sebanyak 28 orang (82,4%) dan mengalami kejadian abortus sebanyak 21 orang (61,8%). Sedangkan hasil uji chi square diperoleh hasil terdapat hubungan yang siginifikan antara pengetahuan dengan kejadian abortus dengan nilai p= 0,007 < 0,05. Diharapkan kepada tenaga kesehatan dapat meberikan informasi tentang faktor-faktor yang berhubungan dengan kejadian abortus kepada ibu hamil yang berkunjungan ke RSUD, agar ibu dapat mengetahuinya dan dapat melakukan pencegahan terhadap kejadian abortus

Background: To study the Feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion.Methods: A cross sectional observational study was conducted over a period of two years. Study included 80 consenting females at 28 weeks POG. Females with history of prior surgical abortion just before the present pregnancy were included as cases (n=40) and rest as controls (n=40). Detailed obstetric history was taken, subjects were then followed till delivery and feto-maternal outcomes such as period of gestation, mode of delivery birth weight, Apgar score, increased NICU stay at the time of delivery were recorded and analyzed.Results: We observed that the women with history of induced surgical abortion were at increased risk of Pre term birth (52.5%, p value0.006), Cesarean section (40%, p value 0.012), Low birth weight (47.5%, p value

The objective was to identify predictors of postabortion long-acting reversible contraception (LARC) initiation to increase providers' understanding of motivators of contraceptive choices.We prospectively enrolled a cohort of women having abortions at13 weeks' gestational age who were eligible to receive no-cost contraceptive methods immediately postprocedure (N=1662) to evaluate the demographic and reproductive factors associated with choosing and receiving a long-acting contraceptive versus a short-acting method. We used stepwise logistic regression to identify independent predictors of LARC initiation.During the study period, 1072 (64.5%) chose an immediate postabortion LARC method and 590 (35.5%) chose another method. Compared to the group of women who chose a non-LARC method, women who chose a LARC method were more likely to have a surgical abortion and were younger, more likely to be Hispanic, more likely to live greater than 70 miles from the clinic, more likely to have a nonurban address and less likely to have had a prior abortion.We found that the differences in the demographic and reproductive factors of women choosing and receiving postabortion LARC were those which have been shown to be associated with difficulty in accessing contraception. Providers should offer a full range of contraceptive options to women immediately postabortion.Postabortion LARC is more likely to be utilized by women from groups who have been shown to have difficulty accessing traditional family planning clinical care: those who are young, do not live in a city and are from groups with recognized health disparities. Offering postabortion LARC increases the options for these women.

Objective To determine if pregnant, literate women and female community health volunteers (FCHVs) in Nepal can accurately determine a woman’s eligibility for medical abortion (MA) using a toolkit, compared to comprehensive abortion care (CAC) trained providers. Study design We conducted a prospective diagnostic accuracy study in which women presenting for first trimester abortion, and FCHVs, independently assessed each woman’s eligibility for MA using a modified gestational dating wheel to determine gestational age and a nine-point checklist of MA contraindications or cautions. Ability to determine MA eligibility was compared to experienced CAC-providers using Nepali standard of care. Results Both women (n = 3131) and FCHVs (n = 165) accurately interpreted the wheel 96% of the time, and the eligibility checklist 72% and 95% of the time, respectively. Of the 649 women who reported potential contraindications or cautions on the checklist, 88% misidentified as eligible. Positive predictive value (PPV) of women’s assessment of eligibility based on gestational age was 93% (95% CI 92, 94) compared to CAC-providers’ (n = 47); PPV of the medical contraindications checklist and overall (90% [95% CI 88, 91] and 93% [95% CI 92, 94] respectively) must be interpreted with caution given women’s difficulty using the checklist. PPV of FCHVs’ determinations were 93% (95% CI 92, 94), 90% (95% CI 89,91), and 93% (95% CI 91, 94) respectively. Conclusion Although a promising strategy to assist women and FCHVs to assess MA eligibility, further refinement of the eligibility tools, particularly the checklist, is needed before their widespread use.

Aims: This study was conducted to find out choice and acceptance of contraceptives in clients coming for first trimester abortion. Methods : This was a cross sectional descriptive study carried out from the records of clients who received comprehensive abortion care service in first trimester at Kasthamandap health care centre from June 2008 to June 2010. Results : Total 707 clients came for abortion who fulfilled inclusion criteria. Contraceptive acceptance was 49.5%. Most frequently used contraceptives were injectable (depot medroxyprogesterone) 22.8%, oral contraceptive pills 19.6%, condom 6.1%, intra-uterine contraceptive device 0.8% and norplant 0.3%. Conclusions: This study showed a low acceptance rate of contraception. This suggests the need for reviewing the policy of post abortion contraception. The study also highlighted that depot provera was the most accepted contraception. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 14-17 DOI: http://dx.doi.org/10.3126/njog.v8i1.8854

Objectives: The primary objective of this study was to assess the current intrauterine device (IUD) knowledge and counseling practices of US obstetrics and gynecology chief residents. The secondary objective was to evaluate the current IUD experience of obstetrics and gynecology residents. Methods: A Web-based survey about IUD knowledge and practices was sent to US obstetrics and gynecology residents in January 2010. An analysis of responses by postgraduate year was completed using descriptive statistics. Results: We received 699 surveys (36%) from a pool of 1922 residents in 96 different residency programs. A total of 654 respondents (94%) had placed an IUD during residency and 88% had received formal teaching about IUDs during residency. Only 53% of respondents knew that the copper IUD could be used for emergency contraception. Less than 65% of respondents would routinely recommend the IUD to adolescents or immediately after first trimester abortion. Conclusions: Many US obstetrics and gynecology residents lack knowledge about IUD benefits and do not counsel all eligible women to use IUDs. We should continue to evaluate our training and educational programs to ensure that women’s health providers do not act as a barrier to IUD use.

Immediate post-abortal period is an appropriate time to provide counselling regarding family planning methods. IUCD insertion in the immediate post-abortal period is safe, both after the induced an...

Aims and Objectives of Study: To compare the diagnostic accuracy of clinical and ultrasound evaluation in first trimester abortions and assess the impact of ultrasound on patient management. Study Design: Non-interventional comparative study conducted o n 100 patients, selected o n simple random basis from Gynae Outpatient Department. Study place: Department of Obstetrics & Gynaecology, Allama Iqbal Medical College and Jinnah Hospital, Lahore Materials and Methods: All the patients with symptoms of first trimester abortion were evaluated clinically and by ultrasound to formulate a diagnostic and management plan. Main Outcome Measures: Both Modalities were compared for diagnostic accuracy, positive and negative correlation in different types of abortions. Results: 34% of the patients were at l0 weeks of gestation, 28% were unsure of dates, 17% were at 11 weeks of gestation, 13% of the patients were at 9 weeks of gestation, 5% were at 6 weeks while 3% were at 7 weeks of gestation. Clinical diagnosis was made in 42% of cases; in 39% definite diagnosis was possible with combined clinical and ultrasound evaluation while in 19% no diagnosis was established with either modality In 89% of the cases the diagnosis was made on single ultrasound scan, while 11% required a repeat scan. Correlation between two modalities was present in 81% of the cases. Positive correlation was obtained in 59% and negative correlation was seen in 22% . The correlation was not possible in 19% of cases. Conclusion: Ultrasonography is an essential tool in diagnosis of early pregnancy failures especially where clinical evaluation is inconclusive.