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Explore the various methods of birth control, including natural methods, barrier methods, and oral contraceptives, as well as the importance of reproductive and child healthcare. Learn about sexually transmitted diseases and how to prevent them.
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REPRODUCTIVEHEALTH–PROBLEMANDSTRATERIES: • Theprogramme“family planning” initiated in 1951. • Reproductiveandchildhealthcare(ACH) • Sexuallytransmitteddiseases(STD). • Amniocentesis:Afetalsexdeterminationtestbasedonthechromosomalpatternintheamnioticfluidsurroundingthedevelopingembryo. • „Saheli‟ an oral contraceptive for female, developed by CDRI.
POPULATIONEXPLOSIONANDBIRTH CONTROL • Increasedhealthfacilities,betterlivingconditionsarethecause • ofpopulationexplosion. • Outof6billionworldpopulation1billionareIndians. • Rapiddeclineindeathrate,maternalmortalilityrate(MMR)andinfantmortalityrate(IMR)aremajorcauseofpopulationgrowth. • Indianpopulationgrowthrateisaround1.7percent.
Characteristicsofidealcontraceptive • Userfriendly. • Easilyavailable. • Effective • Nororleastside–effects. • Nowayinterfereswithsexualdrive
BIRTHCONTROLMETHODS: • Naturalmethods: • workontheprincipleofavoidingchancesofovumandspermsmeeting. • Periodicabstinence: • Avoidorabstainfromcoitusformday10to17ofthemenstrualcycle • whenovulationcouldbeexpected. • Chanceoffertilizationisveryhighinthisperiod. • Itiscalledfertileperiod. • Withdrawalorcoitusinterruption: • Themalepartnerwithdrawshispenisfromthevaginajustbeforeejaculation,soastoavoidinseminationintothevagina. • Lactationalamenorrhea: • Nomenstruationduringlactationperiod. • Chanceoffertilizationisnil. • Itiseffectiveuptosixmonth.
Barriermethods: • • Principleofworking:preventsphysicalmeetingofspermandovum. • Suchmethodsavailablebothformaleandfemale. • Condoms: • Barriersmadeofthinrubber/latexsheath. • Usedtocoverthepenisinmaleorvaginaandcervixinthefemale. • Usedjustbeforecoitussothatsemennotenteredintothefemalereproductivetract. • Maleandfemalecondomsaredisposable. • PreventsAIDSandSTDs. • Diaphragm,cervicalcapsandvaults: • Barriersmadeofrubber. • Insertedintothefemalereproductivetracttocoverthecervix. • Preventsconceptionbyblockingtheentryofspermthroughcervix. • Theyarereusable.
IntraUterineDevices: • Thesedevicesareonlyusedbyfemale. • Insertedbydoctororbyexpertnursesintheuterusthrough • vagina. • Non-medicatedIUDse.g.Lippesloop. • CopperreleasingIUDs(CuT,Cu7,Multiload375) • HormonereleasingIUDs(Progestasert,LNG-20) • Principleofworking: • Increasephagocytosisofspermwithintheuterus. • Cuionreleasedsuppressesspermmotilityandfertilizingcapacityofsperm. • HormonereleasingIUDsmaketheuterusunsuitablefor • implantationandthecervixhostiletothesperm.
Oralcontraceptives: • Thismethodsusedbyfemaleonly. • Usedintheformoftabletshencepopularlycalledpills. • Pillscontainprogestogensorprogestogen-estrogencombination. • Pillshavetobetakendailyforaperiodof21days. • Startedwithinfirstfivedaysofmenstruation. • Pillsareveryeffectivewithlessersideeffect. • Saheli-anonsteroidalpreparationusedasoralcontraceptivepills. • Principleofworking: • Inhibitovulation. • Inhibitimplantation. • Alterthequalityofcervicalmucustoprevent/retardentryofsperms.
Injectionsorimplants: • Progestogensaloneorincombinationwithestrogenusedasinjectionsorimplantsundertheskinbyfemale. • Modeofactionissimilarasinpills • Itisveryeffectiveforlongperiods. • Emergencycontraceptives: • Thesemethodsareusedwithin72hoursofcoitus,rapeor • casualunprotectedintercourse. • Administrationofprogestogensorprogestogen-estrogencombination. • UseofIUDs.
Surgicalmethods: • Itisalsocalledassterilizationmethod. • Advisedtobothmaleandfemalepartner. • Permanentorterminalmethodtopreventpregnancy. • Sterilizationprocessin male iscalled„vasectomy, • Sterilizationprocess infemale is called„Tubectomy’ • Invasectomy,asmallpartofthevasdeferensisremovedortiedup. • InTubectomyasmallpartofthefallopiantubeisremoved. • Reversibilityisverypoor.
MEDICALTERMINATIONOFPREGNANCY: • Intentionalorvoluntaryterminationofpregnancybeforefulltermiscalledmedicalterminationofpregnancy(MTP)orinducedabortion. • MTPhassignificantroleindecreasingpopulation. • Itaccountsfor1/5thofthetotalnumberofconceivedpregnancies. • Legalrestrictiononlytoreducefemalefoeticide. • Thismethodissafewithin1sttrimester.
SEXUALLYTRANSMITTEDDISEASES: • Diseasesorinfectionswhicharetransmittedthroughsexualintercourse. • AlsoknownasVenerealdiseases(VD)orreproductivetractinfections(RTIs) • Gonorrhea,Syphilis,Genitalherpes,chlamydiasis,genitalwarts,trichomoniasis,hepatitis-BandHIVaresomecommonSTDs. • Excepthepatitis-B,genitalherpesandHIVinfections,othersarecurable. • Symptoms: • Itching,fluiddischarge,slightpain,swellinginthegenitalregion. • STDsremainasymptomaticinfemaleandremainundetectedforlong. • InthelaterstageitmayleadstoPelvicinflammatorydiseases(PID),abortion,stillbirths,ectopicpregnancy,infertilityorevencancerinRT. • Preventions: • Avoidsexwithunknownpartners/multiplepartners. • Alwaysusecondomsduringcoitus. • Incaseofdoubt,consultwithaqualifieddoctorforearlydetection. • Getcompletetreatmentifdiagnosedwithdisease.
INFERTILITY: • Thecoupleunabletoproducechildreninspiteofunprotectedsex. • Thereasonofinfertilitymaybe:- • physical, • congenital, • diseases, • drugs, • immunologicalor • Evenpsychological. • Problemsofinfertilitymaybeinmaleorfemale. • Infertilitycliniccandiagnoseandcorrectthecauseofinfertility. • Incasetherenocorrectionsarepossible,somespecialtechnologiesusedtohavechildrencalledassistedreproductivetechnologies.(ART)
Assistedreproductivetechnologies: • (a)Invitrofertilization: • Fertilizationoutsidethebodyinthelaboratory. • Conditioncreatedinlaboratorysimilartothebody. • (b)Embryotransfer: • Popularlyknownastesttubebabyprogramme. • Ovafromthewife/donorandspermfromthehusband/donorarecollectedandinducedtoformzygoteundersimulatedconditionsinthelaboratory. • Thezygoteorearlyembryos(withupto8blastomeres)couldbetransferredintothe fallopiantube. • ZIFT-Zygoteintrafallopiantransfer. • IUT-IntraUterinetransfer(embryowithmorethan8blastomeres). • Furtherdevelopmenttakenplacewithinthefemalebody. • Embryoformedbyin-vivofertilizationcanalsobetransfertoassistthosefemalewhocannotconceive.
(c)Gameteintrafallopiantransfer-GIFT • Transferofovumcollectedfromthedonorintothefallopiantubeofanotherfemalewhocannotproduceit. • Suchfemalecanprovidesuitableenvironmentforfertilizationanddevelopment. • (d)Intracytoplasmicsperminjection(ICSI): • Thespermisdirectlyinjectedintotheovum. • AfterinvitrofertilizationeitherZIFTorembryotransfertechniqueis • followed. • (e)Artificialinsemination(AI) • Semeniscollectedeitherfromthehusbandordonorisartificiallyintroducedintovaginaorintotheuterus(IUI-intrauterineinsemination)ofthefemale. • Suchtechnologyisusefulincaseseitherthemalepartnerunabletoinseminatethefemaleorverylowspermcountsintheejaculates.
Abbreviation • IUCD:IntraUterineContraceptiveDevice • RCH:ReproductiveandChildHealth care • STD:SexuallyTransmittedDisease • HIV:humanImmunodeficiencyvirus. • AIDS:Acquiredimmunodeficiency syndrome • CDRI:CentralDrugResearchInstitute • MMR:MaternalMortalityRate • IMR:Infantmortalityrate. • MTP:MedicalTerminationofPregnancy • VD:VenerealDisease • RTI:ReproductiveTractInfection • PID:PelvicInflammatoryDisease • ART:AssistedReproductiveTechnologies • IVF:InVitroFertilisation • ZIFT:ZygoteIntraFallopianTransfer • AI:Artificialinsemination • IUI:Internauterineinsemination. • ET:Embryotransfer. • IUT:intrauterinetransfer. • ICSI:IntraCytoplasmicSpermInjection.