Sonographic detection of fluid collections and postoperative morbidity following Cesarean section and hysterectomy

Antonelli, E.; Morales, Michel; Dumps, Patrick; Boulvain, Michel; Weil, Alven M.

doi:10.1002/uog.1023

Cited by 26 publications

(29 citation statements)

References 12 publications

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“…Second cause of fever was vaginal vault infection. 5 Pelvic fluid collection was seen in 12 of our cases who had fever and vaginal discharge. Antonelle's has reported 10 percent of his vaginal hysterectomy patients had pelvic fluid collection, fever and vaginal discharge.…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 71%

“…Pain, fever, wound sepsis, anemia, and intra operative complications like hemorrhage and injury to soft tissues, paralytics ileus were early morbidity factors. [1][2][3][4][5][6][7] Relaparotomy was done in one woman within 12 hours for slippage of ligature. 4 In women who had fever and wound infection, wound smear from skin incision was taken.…”

Section: Methodsmentioning

confidence: 99%

“…Pelvic fluid collection assessment, by USG was done in women with vault hematoma and vault cuff infection. 5,[8][9][10] Follow-up morbidity was assessed at 4 weeks post operatively. Local examination of abdominal wound and vault inspection was done in all cases who came for follow-up.…”

Section: Methodsmentioning

confidence: 99%

“…Antonelle's has reported 10 percent of his vaginal hysterectomy patients had pelvic fluid collection, fever and vaginal discharge. 5 Third important fever morbidity was due to urinary infection. In 20 % of our cases (n=24).…”

Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 99%

“…1,2,[4][5][6] Soft tissue injuries are directly proportional to increase in morbidity, surgery time, blood loss and hospital stay. 3 Pre-operative assessment of anemia, size, site, number and nature of tumor and previous surgery is very important so that proper precautions can be taken prior to surgery.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Post Hysterectomy morbidity: a suburban teaching hospital experience in Kanchipuram, Tamil Nadu, South India

Lakshmi

Sheela

Munusamy

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hysterectomy is the removal of uterus for benign uterine tumor and uterine descent in perimenopausal women. Post hysterectomy and follow up morbidity in rural women is studied over a period of 1 year. They were reviewed during hospital stay to identify morbidity and risk factors for prolonged hospital stay and formulate modalities to reduce morbidity. Risk factors assessed were fever, wound sepsis, anemia, previous post-operative adhesions and injury to other organs. Follow up was done at 4 weeks. 72% women were morbidity free. 46% women had more than one morbidity. The aim of this study is to analyse immediate and late post hysterectomy morbidity in a rural setup and to identify risk factors for prolonged hospitalization and formulate modalities to reduce morbidity and duration of hospital stay. Method: Perimenopausal women who underwent hysterectomy for benign uterine conditions and uterine descent were studied for post-operative morbidity at SSSMCRI over a period of one year. Post hysterectomy morbidity was clinically assessed from day one of surgery till discharge, for early and late morbidity. Abdominal skin incision smear, vault smear, urine culture and USG pelvis for collection of fluid was done in woman who developed fever. Follow-up morbidity was done at 4 weeks. Hysterectomy done for malignant conditions were excluded from the study. Results: In rural women, postoperative morbidity was assessed in 81 abdominal, 32 vaginal hysterectomy. Postoperative pain was felt by all 113 women for first 3 days. Fall of hemoglobin due to haemorrhage was seen in 43 (38%) women. 33 needed post-operative blood transfusion. Surgical site infection was seen in 13, needed re-suturing in 7. Fever was seen in 50 women (44%) due to UTI (E coli 13, Klebsiella 5). Pelvic fluid collection was seen in 9 with vault infection. We had one burst abdomen, one re-laparotomy, 3 bladder injuries. Prolonged hospital stay was seen in 41 women. 46% had more than one morbidity. Follow-up at 4 weeks, 72% were morbidity-free. Prolene granuloma 2, Stitch abscess 9, vaginal discharge 14, vault granuloma 3 were observed. Vaginal smear showed 9 Staphylococcus aureus and 5 bacterial vaginosis infection. 12 women had E. coli and 6 Klebsiella infection in urine culture. Conclusion: Pre-operative risk factors for post op morbidity like anemia, urinary and vaginal infection should be properly treated prior to surgery. Awareness of risk factors for morbidity, anticipation of complications due to size, site, nature of tumour and previous surgery adhesions, timely intervention by experienced surgeons and adequate blood transfusion will reduce morbidity and prolonged hospital stay.

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Section: Total Number Of Hysterectomies Done Was 113mentioning

confidence: 71%