A para 2 poorly compensated cardiac patient has delivered 2 days back. You will advice her to:
Correct Answer: Suggest her husband to undergo vasectomy
Description: Contraception in patient of heart disease:
Temporary contraception of choice:
Barrier contraceptives (condoms) but they have high failure rate, so nowadays progesterone only contraceptives like minipills are being advised (Ref Mgt of high risk pregnancy, Manju puri, S Strivedi p376)
Contraception to be avoided:
– OCPs
– Intrauterine devices
Permanent contraception of choice:
Best: Husband should be advised vasectomy especially in patients whose heart is not well-compensated.
If husband refuses or, if heart of the patient is well-compensated-Tubectomy is advised.
Female sterilisation:
Best time: At the end of first post partum week.
Method: Mininlaparotomy (never do laproscopic sterilisation in heart disease patient).
Anaesthesia of choice: Local anaesthesia.
Category:
Gynaecology & Obstetrics
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