cience

Dept. of Gynaecology

Head of Department:Dr.K.J.Coyaji

The Gynaecology department of KEM Hospital, Pune has been actively involved in research fields concerning womens' reproductive health matters. Dr. K.J.Coyaji, Director and Head of ob-gy department, KEM Hospital, and Medical Director of KEM Hospital,Pune is the Principal Investigator for Research Projects. Dr Suhas Otiv, Dr S.S Ambardekar and Dr B.R Edlabadkar are the research scientists. Mrs S.D.Shinde, Mrs S.B. Mhatre, Ms Gayatri Kangare are our medical social workers.

K.E.M. Hospital Research Center(KEMHRC) in collaboration with Population Council, New York has been the pioneer of studies on medical abortion for first trimester in India. It has been the only research center to have done research in medical abortion in both rural and urban settings way back in 1994.

Medical abortion for early pregnancy upto seven weeks is now an accepted method and has been included in MTP Act by Govt. of India from 2002 onwards. Our research showed that medical abortion is feasible and acceptable both in rural and urban community of India. Lancet published our findings "Mifepristone abortion outside the urban research hospital setting in India" in Jan 2001.

Since Mifepristone, the key drug for medical abortion was not freely available in many countries, trials were conducted using Misoprostol alone for medical abortion in KEMHRC along with other countries like Vietnam and America in 2001-2002. As results were not very encouraging further research was stopped; Mifepristone was freely available by then.

KEMHRC has done research not only on early first trimester abortions, but also on late first trimester and second trimester abortions

Apart from abortion, KEMHRC has been working on "Emergency Contraceptive" and cafeteria approach for family planning methods, trial for Norplant as a contraceptive.

Emergency contraception is not practiced as a routine in India. We had a very interesting project about providing information, knowledge and advance supply of emergency contraceptive to all rural and urban community. The response was encouraging.

KEMHRC has also collaborated with Rockefeller Foundation, NewYork, for developing new algorithms for the treatment of vaginal discharge

KEMHRC has also done an interesting project on measuring blood loss during vaginal delivery using caliberated BRASSS-V Drape and the standard WHO method. The results showed that the Drape method is easier to use and is as accurate as the WHO method for measuring blood loss during delivery. This aids in early diagnosis and prompt management of PPH.

KEMHRC has been working with ICMR, New Delhi on various reproductive health projects. One of them was Phase IV Multicentric Task force study on Centchroman a non steroidal oral contraceptive drug. The dose is one tablet twice a week orally during first three months and later on one tablet once a week . The efficacy of this method was not as expected. Moreover the rate of complications like simple ovarian cyst was also very high. Hence we discontinued this study.

As of now KEMHRC is working on "Evaluation of Progesterone Vaginal ring as a new method of contraception in lactating women". We are evaluating the efficacy and acceptability of this method in our setting. This project is being carried out in collaboration with Population Council, New York.

"Teenage pregnancy and its outcome" is another project that we are working with ICMR, New Delhi. Since the rate of teenage pregnancy is rising. We are interested in studying the pregnancy outcome in these women as compared to the outcome in pregnant women in the age group of 20 yrs to 25 yrs.

"Hospital based surveillance of female genital tract fistula" was another study done in collaboration with ICMR, New Delhi . Since there is no national registry which maintains data on female genital tract fistula a study was undertaken across India to study the prevalence rate and also to study the knowledge, attitude and practices due to fistula in these women.

PUBLICATIONS:

A. Research Publications:

1. Coyaji KJ. Maternal Nutrition, Health Administrator 1987;5: 42.

2. Coyaji KJ. (Principal Investigator, Poona HRRC) ICMR Multicentric Trial: Randomized Clinical Trial with Intrauterine Devices (Levonorgestrel Intrauterine Device, CuT 380 Ag, CuT 220 C and CuT 200). Contraception 1989; 39: 11, 37.

3. Coyaji KJ, Otiv SR. Single High Dose of Intravenous Phenytoin Sodium for the Treatment of Eclampsia. Acta Obstet Gynecol Scand 1990; 68: 115-118.

4. Coyaji KJ. Anti Progestin: A Review. Med J West India 1991; 19:1-11.

5. Coyaji KJ. (Principal Investigator, Poona HRRC) Joint Publication of ICMR Task Force Study: Evaluation of Quality of Family Welfare Services at Primary Health Centre Level. 1991.

6. Rao VN, Coyaji KJ, Palkar ND,Sidhaye AB. Intervention for improving quality of existing family planning and MCH services at the PHC level. Population Research Abstract, Applied Population Research Trust 1991; 2:1.

7. Coyaji K, Krishna U, Patel D, Kambo I, Nair A, Saxena BN. An evaluation of Prostaglandin A1 in Pre-eclampsia. J Obstet Gynecol India 1992; 42:6, 737-742.

8. Coyaji KJ. (Principal Investigator, Poona HRRC) ICMR Multicentric Trial: Fetal Growth Parameters - Clinical versus Ultrasonographic. The Ind J Paed, 1992: Vol. 59, No. 1.

9. Coyaji KJ. (Principal Investigator, Poona HRRC) ICMR Multicentric Trial: Improved Utilization of Spacing Methods - intrauterine devices (IUD) and low-dose combined oral contraceptives (COC) - through re-orientation training for improving quality of services. Contraception Sept 1994:50;215.

10. Winikoff W, Sivin I, Coyaji K, Cabezas E, Bilian X, Sujuan G, Ming-kun D, Krishna U, Eschen A, Ellertson C. Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: A comparative trial of mifepristone -misoprostol versus surgical abortion. Am J Obstet Gynecol 1997; 176: 432.

11. Winikoff W, Sivin I, Coyaji K, Cabezas E, Bilian X, Sujuan G, Ming-kun D, Krishna U, Eschen A, Ellertson C. The Acceptability of Medical Abortion, In China, Cuba and India. International Family Planning Perspectives 1997; 23:73

12. Ganatra BR, Coyaji KJ, Rao VN. Too far, too little, too late: a community based case control study of maternal mortality in rural west Maharashtra, India. Bull WHO, 1998; 76 (6): 591-598.

13. Harper C, Winikoff B, Ellertson C, Coyaji K. Blood loss with mifepristone – misoprostol abortion: measures from a trial in China, Cuba and India. Intern J Gynecol Obstet 1998; 63: 39 – 49.

14. Elul B, Ellertson C, Winikoff W, Coyaji K. Side Effects of Mifepristone-Misoprostol

Abortion versus Surgical Abortion. Data from a Trial in China, Cuba, and India.

Contraception 1999; 59:107

15. Fall CHD, Yajnik CS, Rao S, Coyaji KJ, Shier RP.

The effects of maternal body composition before pregnancy on fetal growth: the Pune Maternal Nutrition and Fetal Growth Study. In: Fetal Programming: Influence on Development & Disease in Late Life.

Editors: O'Brien PMS, Wheeler T, Barker. RCOG Press 1999.

16. Ellertson E, Elul B, Ambardekar S, Wood L, Carroll J, Coyaji K.

Accuracy of assessment of pregnancy duration by women seeking early abortions. Lancet 2000; 335: 877-881.

17. Vishwanath S, Talwar V, Prasad R, Coyaji K, Elias C, de Zoysa I.

Syndromic management of vaginal discharge among women in a reproductive health clinic in India.

Sex Transm Inf 2000;76:303-306.

18. Coyaji K.

Early Medical Abortion in India: Three Studies and Their Implications for

Abortion Services.

JAMWA 2000; 55:191-194.

19. Blanchard K, Winikoff B, Coyaji K, Ngoc NTN. Misoprostol alone – A New Method of Medical Abortion?

JAMWA 2000; 55:189–190.

20. Kurus Coyaji, Batya Elul, Usha Krishna, Suhas Otiv, Shubha Ambardekar, Arti

Bopardikar, Veena Raote, Charlotte Ellertson, Beverly Winikoff.

Mifepristone abortion outside the urban research hospital setting in India.

Lancet 2001; 357:120 – 121.

21. Kurus Coyaji, Batya Elul, Usha Krishna, Suhas Otiv, Shubha Ambardekar, Arti

Bopardikar, Veena Raote, Charlotte Ellertson, Beverly Winikoff.

Mifepristone – misoprostol abortion a trial in rural and urban Maharashtra, India.

Contraception 66 2002; 33 – 40.

22. Allison Hedley, Charlotte Ellertson, James Trussell, Abigail Norris Turner, Elisabeth Aubeny, Kurus Coyaji, Nguyen Thi Nhu Ngoc, Beverly Winikoff.

Accounting for time: Insights from a life-table analysis of the efficacy of medical abortion.

Am J Obstet Gynecol 2004; 191, 1928–33.

23. Ujjwal A. Nene, Kurus Coyaji, Hemant Apte.

Infertility: A label of choice in the case of sexually dysfunctional couples.

Patient Education and Counselling (2005) 59; 234–238

24. K Coyaji, U Krishna, S Ambardekar, H Bracken, V Raote, A Mandlekar, B Winikoff. Are two doses of misoprostol after mifepristone for early abortion better than one?

Bri J Obstet Gynaecol 2007; 114:271– 278.

25. H Bracken, Nguyen Thi Nhu Ngoc, Eric Schaff, Kurus Coyaji, Shubha Ambardekar, Emily Westheimer, B Winikoff.

Mifepristone Followed in 24 Hours to 48 Hours for Late First–Trimester Abortion.

Obstet Gynecol April 2007;109 ( 4), 895–901.

B. Chapters in Books:

1. Coyaji KJ (1993) Methods for Termination of Pregnancy.

In Krishna UR, Coyaji BJ, Bhaskar Rao K, Raghavan KS (Eds.) Safe Motherhood, 72-82. The Federation of Obstetric and Gynaecological Societies of India.

2. Coyaji KJ (1993) Intra Uterine Growth Retardation.

In Krishna UR, Daftary S (Eds.) Pregnancy at Risk: Current Concepts 306 - 316. The Federation of Obstetric and Gynaecological Societies of India.

3. Coyaji K, Otiv S. Fetal Growth Restriction.

In Krishna UR, (Eds.) Pregnancy at Risk 4th edition

Contact:

020-26125600 Extn:7319/7320