A P2L2 poorly compensated cardiac patient delivered 2 days back. Contraceptive advise is
If Patient is hemodynamically unstable better to advise vasectomy for the husband. Contraception in Hea disease Patients Steroidal contraception is contraindicated as it may precipitate thromboembolic phenomenon IUCD's are avoided in fear of infection Progestin only pills are SAFE and EFFECTIVE. They may cause Irregular bleeding if the patient is anticoagulated. Barrier methods is the BEST but failure rate is high Sterilisation should be considered with the completion of family at the end of first week in the puerperium under local anaesthesia through abdominal route by minilap technique. The procedure can be delayed up to several days to ensure that the mother has become hemodynamically near normal and that she is afebrile, not anemic, and ambulating normally. Reference: DC. Duttas textbook of OBG & GYN , 9th edition .Page 260
Undergo sterilization (tubectomy) after 1 week
Undergo sterilization after 6 weeks
Suggest her husband to undergo vasectomy
Oral contraceptive pills after 6 months
Medical, surgical and gynaecological illness complicating pregnancy