Case records and commentaries
Abstract
The grand multiparous patient has almost dissappeared in the
developed countries due to the advancement in family planning. In
our country grand multiparity and its associated problems still exist.
This study was based on 370 grand multiparous patients who were
admitted to Kisii District Hospital in labour during a four month
study period from November, 1990 to February, 1991. Data on this
group was compared to 375 lesser multipara admitted during the
same period, in sociodemographic aspects, antenatal care, pregnancy
and delivery complications, and fetal outcome.
The grand multipara was found to have poor antenatal care,
and higher statistically significant incidences of abruptio placenta,
post partum hemorrhage, large infants, perinatal morbidity and mortality
rates. Various other factors showed' no significant different incidences.
Conclusions and recommendations based on this study are finally
given.
A B s T R A c T
The acceptance of vasectomy as a means of fertility control
still lags that of female sterilization in Kenya. This study was based
on 380 men whose spouses were having tubal ligations done in two
out patient clinics in Kisii during a 5 - month period.
57.8% of the study group had knowledge of vasectomy though
fewer numbers actually understood the speci•fic features of the method
and how it works. 47.7% had vasectomy offered to them as an alternative
to female sterelization. Majority of the men had negative attitudes
towards vasectomy and 65.3% thought the same for their wives. The
commonest source of knowledge for vasectomy was the mass media
(22.6%) whereas that for female sterilization was the community based
family planning agent (31.3%). 80.3% had an idea of where to obtain
vasectomy services.
The commonest reason for tubal ligation was completion of desired
family size in 62.1% whereas 71.6% thought it would be a justifiable
reason for vasectomy. 11.8% of the men had previously practised
male contraception compared to 35.3% of the females. The husband
was the main decision maker for female sterilization in 37.4% of couples.
65.5% thought the spouse's consent was not necessary for vasectomy
whereas 53.2% advocated for separate male sterilization clinics.
Citation
Degree of Masters of Medicine in Obstetrics and GynaecologyPublisher
University of Nairobi School of Medicine
Description
A thesis submitted in part fulfillment
For the
Degree of Masters of Medicine
in
Obstetrics and Gynaecology
of the
University of Nairobi