Emergency peripartum hysterectomy: a 7-year review at tertiary hospital

Emergency peripartum hysterectomy (EPH) is a major obstetric procedure, usually performed as a life-saving measure in cases of intractable obstetric hemorrhage. The aim of this study was to determine the incidence, indications and the risk factors and complications of emergency peripartum hysterectomy (EPH). The medical records of 13 patients who had undergone EPH, between January 2012 and December 2018, were reviewed retrospectively. All necessary data was obtained by record review. The mean age of pregnant women was 30 year. There were 13 EPHs out of 15768 deliveries, a rate of 0.82 per 1,000 deliveries. Out of 13 women who underwent EPHs, 8 hysterectomies were performed after cesarean delivery and 5 after vaginal delivery. The most common indication for hysterectomy was abnormal placentation (7/13), followed by atony (4/13), rupture of scared uterus (1/13) and rupture of unscared uterus (1/13). There were two cases of intra-operative bladder injury, we had 1/13 maternal death because of EPH. There were no cases of neonatal mortality. In our series, abnormal placentation was the most common of indication for EPH. The risk factors for EPH were previous CS for abnormal placentation and placental abruption for uterine atony and peripartum hemorrhage. Limiting the number of CS deliveries would bring a significant impact on decreasing the risk of EPH

ANTIHYPERLIPIDEMIC ACTIVITY OF CASSIA FISTULA BARK USING HIGH FAT DIET INDUCED HYPERLIPIDEMIA

Objective: To study the antihyperlipidemic and anti atherosclerotic activity of Cassia fistula extracts in experimentally induced atherosclerotic rats.Methods: In this study, the antihyperlipidemic activity of Cassia fistula bark was evaluated by the administration of high fat diet. Atherosclerosis was induced in wistar rats by feeding with high cholesterol diet for 21 d. Oral feeding of cholesterol (500 mg/kg b.w./day) dissolved in coconut oil (0.5 ml/rat/day) caused an elevation in total cholesterol, LDL cholesterol, VLDL cholesterol triglycerides serum of rats.Results: Administration of Cassia fistula extracts (methanolic and ethyl acetate extract at 500 mg/kg respectively) along with high cholesterol diet reduced the raised serum level of total cholesterol, triglyceride, LDL, VLDL and increased the serum HDL level as compared to the control group (High cholesterol group). Histopathology study of heart has shown decrease in myocardial degeneration and inflammation which may be attributed to the anti atherosclerotic activity of the Cassis fistula bark extracts.Conclusion: These results suggested that Cassia fistula bark possess significant antihyperlipidemic activity.Â