DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205786

Study the acceptance, compliance and efficacy of injection depot medroxy progesterone acetate as contraception: a prospective observational study

Nupur S. Mane, Jyoti V. Rokade

Abstract


Background: India was the first country in the world to launch a family planning programme, as early as 1952, with the main aim of controlling its population. Depot medroxy progesterone acetate, or DMPA is a progestin-only method of contraception. It is a 3-monthly intramuscular injectable that delivers 150 mg of medroxyprogesterone acetate in microcrystalline suspension form that delays absorption of the hormone after the injection. It provides long acting, effective and reversible contraception. In this study, we evaluated patients in reproductive age group 18-35 years who were willing to use injectable DMPA as a method of contraception to study the acceptance, compliance and efficacy of injection depot medroxyprogesterone acetate as contraception.

Methods: It is a prospective observational study carried out at Government medical college Miraj on 150 patients who fulfil the inclusion criteria. The postpartum, interval and postabortal categorisation of patients done and they are councelled about the benefits and side effects and drawbacks of DMPA. Injection is given deep intramuscularly after written informed consent and a DMPA card is given to beneficiary. Follow up date explained and patients are observed for follow up and any evidence of bleeding weight gain or any other side effects of DMPA are noted.

Results: The mean age of subjects was 24.48±3.494 years. 2) 3.3% of the patients were nullipara, primi para 46.7%, 36% were second para, 11.3%  were third para and  2.7% were fourth par. 3) After 1st injection, 47.3% patients were lost to follow-up i.e., they did not turn up for their second dose of injection. 4) Out of 150 patients who accepted the injection as contraception, only 79 patients turned up for their 2nd injection after 3months, out of which only 37 patients turned up for their 3rd dose of injection after 6 months and only 5 patients turned up for their 3rd injection. Thus showing that the compliance is poor among this study population. 5) At 2nd injection, 39.2% discontinued due to amenorrhea, 10.7% discontinued due to irregular bleeding, 18.5% due to weight gain and 31.6% due undergoing permanent method. 6) No patients who came for follow up reported any pregnancies during the course of injection, therefore the efficacy of injection depot medroxy-progesterone acetate, as a method of contraception is 100% in this study.

Conclusions: The DMPA is a good method of long acting reversible method of contraception with good acceptance and efficacy with less compliance.


Keywords


DMPA, Long acting reversible contraception

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References


National Health Mission, Government of India, 2016. Available at: http://www.nhmmp.gov.in/WebContent/FW/Scheme/Scheme2017/Mission_Parivar_Vikas.pdf.

Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Estimated pregnancy rates for the United States, 1990-2005: an update. Natl Vital Stat Rep. 2009;58:1-14.

Park K. Demography and family planning. In: Park K. Park's Textbook of Preventive and Social Medicine, 24th ed. Jabalpur, India: Banarsidas Bhanot Publishers, 2017:525-552.

Westoff C. Depot medroxyprogesterone acetate injection: a highly effective contraception with proven long term safety. Contraception. 2011;68(2):75-87.

Brownell EA, Fernandez ID, Howard CR, Fisher SG, Ternullo SR, Buckley RJ, Dozier AM. A systematic review of early postpartum medroxyprogesterone receipt and early breastfeeding cessation: evaluating the methodological rigor of the evidence. Breastfed Med. 2012;7(7):10-8.

ACOG Practice Bulletin no 73. Use of hormonal contraception in women with medical disorders. Obstet Gynecol. 2019;107:1453-72.

Rodrigues MI, Kaunitz AM. An evidence of postpartum use of DMPA in breastfeeding women. Contraception. 2009;80(1):4-6.

Sarojini NB, Murthy L. Why women’s groups oppose injectable contraceptives. Indian J Med Ethics. 2005;2(1):8-9.

Department Health Family Welfare. Annual report, 2017-18. Available at: https://mohfw.gov.in/documents/publications/annual-report-department-health-family-welfare-year-2017-18/annual-report-department-health-family-welfare-year-2017-18.

Rai L, Prabakar P, Nair S. Injectable depot medroxyprogesterone-a safe and an effective contraception for an Indian setting,”. Health Popu Perspect Issu. 2007;30(1):12-23.

Fonseca M, Deshmukh PY, Kharat D. DMPA: acceptance and compliance in a tertiary care hospital in Mumbai, India. Int J Reprod Contracept Obstet Gynecol. 2017;6:3879-81.

Sirisha PSNRS. Efficacy of depot medroxyprogesterone acetate as a contraceptive. Intern J Med Res Pharma Sci. 2017;4(12).

Singh P, Vyas RC. Ushma., Yadav, P. Study of Effectiveness of DMPA in Postpartum and Postabortal Period. J Dent Med Sci. 2015;14(2):74-8.

Nautiyal R, Bijalwan R, Maithili B, Sinha LN. Feasibility of injectable Depot medroxyprogesterone acetate in a semi urban camp setting. Int J Reprod Contracept Obstet Gynecol. 2016;5:1056-60.