Research
Emergency Peripartum Hysterectomy in a Tertiary Care Centre and Medical College Of Ranchi, Jharkhand, India : A Retrospective Study
Introduction: Emergency Peripartum Hysterectomy (EPH) is a lifesaving surgical procedure that is associated with maternal mortality and morbidity, especially in developing countries. Worldwide, the rate of peripartum hysterectomy varies widely. Developing countries like India have higher incidence of EPH because more deliveries take place outside health facilities and are unsupervised or poorly supervised. The aim of this study was to find the incidence, indications, risk factors and clinical implications of EPH in a tertiary care referral centre of Jharkhand. Material & Methods: This was a retrospective study to identify and analyse the cases of EPH at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand between May 2018 to april 2019. Observation & Result: During this study period, there were 9006 deliveries with 72 cases of EPH identified giving an incidence of 7:1000. Out of 72, only 50 cases were included in our study as: 36 patients (72%) belonged to 21 -30 years of age group and 14 (28%) were more than 30 years of age. 12 patients (24%) were grand multipara and 38 patients (76%) were between Para1 –Para4. Most of the women (66%) belonged to low socioeconomic status. In 38 patients (76%), the gestational age was between 37 to 40 weeks. Mode of delivery was vaginal only in 3 cases (6%). Primary caeserian section was done in 13 cases and there was history of previous cs in 14 cases.
Rupture Uterus in a Tertiary Care Centre : A Retrospective Study
Introduction: Uterine rupture is a major obstetric hazard. It leads to high maternal and perinatal mortality-morbidity and loss of future fertility. Aims & Objectives: The aim of this study was to calculate the incidence of rupture uterus and study its various aspects in the department of obs & gynae at RIMS, Ranchi, Jharkhand, India. Material & Methods: This was a retrospective study done in the department of obstetrics & gynaecology during September 2017 to August 2018. Data was collected from the registers of labour room, labour OT and medical records department of RIMS, Ranchi. Total cases of rupture uterus cases during the study period were included in the study. There was no exclusion criteria. Incidence of rupture uterus per 1000 deliveries was calculated. Observation & Result: In our study, the incidence of rupture uterus was 10 per 1000 deliveries. All 70 cases were unbooked, had rupture outside RIMS; 60 (85.7%) were referred case ,whereas 10 (14.37%) had no referral paper. 47 (67.1% ) had rupture of previous cs scar, others were non scarred uterus. 57 (81.4%) had rupture of lower uterine segment, whereas 13 (18.6%) had upper segment rupture. 11 (15.7%) had undergone repair of the uterus without tubectomy, 20 (28.6%) had repair with tubectomy. 29 (41.4%) underwent subtotal hysterectomy and total hysterectomy was done in 10 ( 14.3% ) patients .There were 4 maternal mortality cases out of 70 cases of rupture uterus. Fetal mortality was 97%. Only two babies were delivered alive.
