Non-descent vaginal hysterectomy in previous cesarean section: a retrospective study of 30 cases

Background: Non-Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. Objective of present study was to assess safety, feasibility of NDVH in patients with previous cesarean section.Methods: Retrospective study was conducted in department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India from April 2008 to June 2016. Effort was made to perform hysterectomies vaginally in women with benign conditions with history of one, two or three caesarean sections. Information regarding age, parity, number of previous LSCS, uterine size, blood loss, duration of operation, difficulties in separating bladder, intra -operative, post-operative complications were recorded.Results: Total thirty cases were selected for NDVH with history of one, two and three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time vaginally. Thirteen patients had previous one Lower Segment Cesarean Section (LSCS), sixteen had two LSCS and one had three LSCS. Commonest indication was abnormal uterine bleeding followed by leiomyoma of uterus. Mean duration of surgery was 97 min. Mean blood loss was 150 ml. Post-operative complications were minimal. Patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days.Conclusions: Vaginal hysterectomy is safe, cost effective method of hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay and less morbidity

Prevalence of Metabolic Syndrome in Pre as Well as Postmenopausal Women in A Tertiary Care CENTER: A Hospital Based Observational Study

Background: Metabolic syndrome is a constellation of metabolic abnormalities and a complex  pre-disease  state that predicts future development of type 2 diabetes mellitus and cardiovascular diseases. Epidemiologically it is observed that incidence of metabolic syndrome increases with age and more so in women once they attain menopause. Objectives: To study the prevalence of metabolic syndrome in pre as well as post-menopausal women and to study the various components of metabolic syndrome. Materials and Methods: We performed an observational study in a tertiary care teaching institute. Women attending general health checkup were selected for the study A total of 484 women were selected. 267 were in the postmenopausal group and 217 in premenopausal group. After a detailed collection of demographic data, medical, surgical, obstetrical and gynecological history, general physical and systemic examination was done. Height, weight, waist circumference were measured. BMI was calculated. Venous blood sample sent for Fasting blood glucose, HDL, Triglycerides. Metabolic syndrome was diagnosed when three out of five parameters were found abnormal. Results: Metabolic syndrome was seen in 158 women (32.6%). Among these women, 118 (44.19%) were postmenopausal women and 40 (18.4%) were premenopausal. Postmenopausal women are at twice the risk of developing metabolic syndrome