Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.
Background: Abruptio placenta is premature separation of the normally implanted placenta before delivery. It is one of the leading causes of maternal morbidity and neonatal morbidity and mortality, more so because of the difficulty to predict the acute event. It occurs in approximately one in 80 deliveries and remains a significant cause of perinatal mortality and morbidity. Objective of the study was to study maternal and perinatal outcome in cases of abruption.
Methods: 42 cases of pregnant women who presented with abruption placenta to HSK hospital and Research Centre, S. Nijalingappa Medical College, a tertiary care centre at Bagalkot, from January 2022 to December 2022. Maternal and perinatal characteristics were retrieved from the case papers.
Results: Among 42 cases of abruption 70% delivered vaginally and 30% underwent caesarean section. 84% had preterm delivery. 66% were still born. 21% were case of severe anaemia and required blood transfusion. 1 had maternal mortality.
Conclusions: The availability of advanced emergency obstetric care across greater number of referral hospitals has been responsible for decreasing the morbidity and mortality associated with many obstetric conditions. However, the challenge with abruptio placenta is the difficulty of predicting this condition, and hence appropriate management. As of now, early referral to tertiary care centres, better availability of blood and blood products and early interventions have the potential to limit adverse maternal and perinatal outcomes. Research regarding predictors of placental abruption can help in improving maternal and perinatal outcome.
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