An audit of hysterectomies at a tertiary care teaching hospital

Background: Hysterectomy is the second most common major surgical procedure performed on women all over the world next to caesarean section. Emergence of effective medical and conservative treatment for benign conditions in the uterus is now posing a question mark regarding the justification of hysterectomy. It has been realized that uterus should not be considered as a vestigial organ after child bearing. Apart from few population based studies, there is no national level survey done in India which give us the prevalence and indications for hysterectomy in India.Methods: Present study involved all patients who underwent Hysterectomy at Guru Gobind Singh Medical College Faridkot in a span of one year from 1st January 2017 to 31st December 2017.Results: In the year 2017, 250 hysterectomies were done, most common age group was 40-49 years (36.8%) and most common indication was fibroid uterus (40%) followed by ca ovary (19.6%), Abdominal route was most commonly preferred.Conclusions: Hysterectomy was justified in 98% women in our series based on post operative histopathological report of the specimen. However we hypothesize that 20 cases of DUB, 5 cases of CIN and 10 cases of endometriosis and 3 cases of chronic cervicitis could have been managed conservatively. 10 cases of obstetric hysterectomies could have been avoided by disseminating awareness among peripheral centres for early referral and by attempting a rather conservative approach of uterine artery embolizations. As the incidence of carcinoma is increasing in the Malwa region of Punjab people prefer hysterectomies instead of conservative treatment. Hysterectomy is used commonly to improve the quality of life and sometime it is life saving procedure. However it should be justified before taking a direct decision of sacrificing uterus

Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians

Obstetric and perinatal outcome of twin pregnancy: a prospective study in a tertiary care hospital in North India

Background: Multiple pregnancy constitutes an important portion of high risk pregnancies and is a matter of grave concern to obstetricians and paediatricians owing to maternal and perinatal morbidity and mortality associated to it. Objective of present study was to evaluate maternal and perinatal outcome of twin pregnancy.Methods: This observational study included 50 women with twin pregnancy with gestational age of 26 weeks or more. Maternal and perinatal outcomes were studied.Results: The incidence of twin pregnancy was 2.8 % with maximum incidence in age group of 20 -29 years and in multigravida. Mean gestational age was 34.2 weeks. Vertex - vertex fetal presentation was most common presentation. Most frequent mode of delivery was ceserean section (54%). Preterm labour was most common maternal complication (74%), followed by anaemia (62%). Complications in perinatal period were birth hypoxia (58 %), intrauterine growth restriction (15 %), hyper-bilirubinemia (11%) and neonatal sepsis (10 %). 88% of the newborns were LBW. Perinatal mortality in our study was 17%.Conclusions: Twin pregnancies are associated with significant maternal and perinatal morbidity which is more so for second twin. Effective antenatal care planned delivery and good pediatric facilities help decrease the complications. Managment of twin pregnancy requires multidisciplinary approach and involvement of skilled obstetricians and paediatricians