Study on DMPA as postpartum contraception in a tertiary care hospital

Abstract

Background: Injectable Depomedroxyprogesterone acetate(DMPA) is a very safe, convenient, highly effective,reversible,long-acting postpartum contraception without affecting lactation. Objectives: To find out side effects, continuation rate and reasons for discontinuation of DMPA used as postpartum contraception.Material and methods:This Prospective study was carried out on 120 women. Intramuscular DMPA administered every 3 month after 6 weeks postpartum. Data in relation to age, parity, side effects, continuation rate and reasons for discontinuation was statistically analysed using SPSS software and Microsoft Excel. Results were expressed in term of numbers and percentages. Results: 43.33% and 33.33% were in the age group of 21-25 and 26-30 years respectively. 53.34% were Primipara.Irregular bleeding was the most common side effect seen in 36.67%. 20% had secondary amenorrhoea. 7.5% noticed weight gain. 5.83% complaint of headache and 1.67% had acne. Majority (61.66%) discontinued DMPA after first and second dose of injection. 20.84% and 17.5% discontinued after third and fourth dose respectively. Most common reason for discontinuation was its side effects, seen in 68.34%. 16.66% were lost to follow up.15% switched over to another contraception. Most of the users were satisfied with their lactation. No significant alteration of blood pressure was found among DMPA users. No serious adverse reaction was noticed and none of the women became pregnant during DMPA use. Conclusion: Injectable DMPA was found to be safe and highly effective postpartum contraception without any adverse affect on lactation. Pre-use counselling on expected side effects along with regular follow-up increases the acceptance and continuation rate.