Presentation and Management of Patients With Obstetrical and Gynecological Complications in the Department of Surgery

Ainul Hadi, Shehla Faridoon, Farrukh Ozair Shah, Tilal Ahmed Raza, Shehzad Akbar Khan

Abstract

Objective

To find out the type of obstetrical and gynecological complications and their subsequent treatment in the department of general surgery.

Study design

Descriptive case series.

Place & Duration of study

Department of Surgery, Hayatabad Medical Complex (HMC) Peshawar, from July 2017 to June 2020.

Methodology

Patients who presented either in emergency room within 24-48 hours following surgery or those referred to outpatient department after 48 hours of the procedure were included. Emergency cases included postoperative complications during obstetrical and gynecological procedures performed in the department of Obstetrics and Gynecology at HMC and those referred from peripheral hospitals. These emergencies were managed immediately while other patients underwent surgery on elective operation list. Patients were followed up in the OPD. Data were analyzed through SPSS version 16.

Results

A total of 56 patients with the mean age of 28±3.5 year were managed. Thirty-five (62.5%) patients were referred from hospitals in periphery and 21 (37.5%) from HMC. Twenty-four (42.8%) patients presented to accident and emergency department while 32 (57.2%) were referred to outdoor department. The initial surgeries, during which complications occurred, included total abdominal hysterectomy (n=34 - 64.3%), pelvic mass excision (n=8 - 14.3%), cesarean section (n=8 - 10.7%), vaginal hysterectomy (n=3 - 5.4%), myomectomy (n=2 - 3.6%) and dilatation and curettage (n=1 - 1.8%). The most common complication was wound infection (n=13 - 23.2%) followed by hemorrhage (n=9 - 16.1%). Patients underwent debridement and dressing (n=13 - 23.2%), hemostasis (n=9 - 16.1%) and mesh repair (n=8 - 14.3%) for incisional hernia. There was no mortality in emergency as well as cold cases.

Conclusion

Total abdominal hysterectomy, cesarean section and vaginal hysterectomy were the commonly performed procedures that resulted in number of complications for which treatment in general surgery department was needed. 

Key words

Rectovaginal fistula, Total abdominal hysterectomy, Uterine myomectomy, Vesicovaginal fistula.