Pre-and post delivery contraceptive use in women with cardiac
diseases and pregestational diabetes mellitus
S. Ozalp, T. Sener, H.M. Tanir, B.
Oney
Eskisehir Osmangazi University School of Medicine, Department of Obstetrics
and Gynecology, Eskisehir, Turkey
Objective In this study, we evaluated the
preferences of contraceptive methods among women delivered and complicated with
cardiac diseases and pregestational diabetes mellitus (PgDM) before and after
delivery. The aim of this study was to implement family planning counselling
services to these groups in order to choose the best effective and safe
contraceptive method.
Design and methods The study group consisted of 31 women
with PgDM and 60 women with cardiac diseases. After delivery, all cases were
counselled regarding the effective and modern contraceptive methods. A telephone
survey was conducted for the study group to evaluate their contraceptive use
after delivery.
Results Prior to their last pregnancy, 23 (38.7%) women
complicated with cardiac diseases were not using any contraceptive method.
Within same group, coitus interruptus (CI), condom, intrauterine device (IUD),
oral contraceptives use were seen 13 (21.7%), 9(15%), 10 (16.7%), and 5(8.3%)
cases, respectively. In PgDM group, numbers of condom+CI, IUD and oral
contraceptives use were 6 (19.4%), 3(9.7%) and 4(12.9%), respectively. Of 23
women complicated with cardiac diseases and not using any form of contraception
prior to pregnancy, 22(95.6%) began to use a modern and efficient form of
contraception after delivery. All of women with PgDM not using any form of
contraception began to use effective contraception following delivery. The most
preferred methods following the delivery in cardiac diseases group were IUD
(41.7%) and condom use (28.3%). These figures for PgDM group were 32.3% and
41.9%, respectively. In cardiac disease group, of 13 women using CI, 8 (53.3%)
cases began to use effective contraception following postpartum counselling.
Conclusions In women with medical problems, it is crucial to reduce the risk of
unwanted pregnancies. For this reason, choice of contraception should be made
according to medical problems. Pelvic infection should be ruled out before IUD
application among women with cardiac diseases. During follow-up, these women
should be counseled regarding signs and symptoms of pelvic infections.