ABSTRACT
Objectives: Importance of information provision by the gynaecologist and its effects on women`s decision making about hysterectomy
Design of Study: Structured questionnaire and interview
Setting: Department of Obstetrics and Gynaecology, Jinnah Hospital, Lahore
Materials and Methods: A questionnaire was given to 50 women who had undergone hysterectomy for benign menstrual problems and information was collected. Main Outcome Measures: Women`s experience and satisfaction, with the communication and information provision by the doctor about her disease before hysterectomy. To assess the influence of that counseling on the decision-making process of hysterectomy
Results: Most of the women undergoing hysterectomy were between the age group of 40 - 45yrs [40%]. Most common indication for hysterectomy was dysfunctional uterine bleeding [55%]. 32% women reported optimal satisfaction with decision made. 57 highlighted sub-optimal aspects of decision-making process. 37% complained of deficiency in communication skills of doctors and 63%, stated that information provided were incomplete [P<.001]. 11% had residual doubts about the appropriateness of hysterectomy
Conclusion: The efforts are required to ensure that women are adequately informed and involved in decision about gynecological treatment
ABSTRACT
Aims and Objectives of Study: To compare the safety and efficacy of Ritodrine and Salbutamol in the management of preterm labour
Study Design: It was an interventional study in which the comparison between Salbutamol and Ritodrine was carried out for the prevention of preterm labour
Study Setting: Department of Obstetrics and Gynaecology, AIMC/ Jinnah Hospital, Lahore
Patients and methods: 50 patients admitted for prevention of preterm labour were randomly assigned to two groups having 25 patients in each group. One group was given 100mg Ritodrine [group I] in 500ml of 5% Dextose water, starting at a dose of 50Microg/min and increased by 50Microg/min every 15-30min till uterine activity ceased or dose of 350Microg/min reached or other in tolerable side effects appeared. The effective tocolytic dose without side effects was maintained for 24 hours during this period steroid cover was given. Another group was given 5mg Salbutamol [group-II] in 500ml of 5% D/S, at a dose of 10Microg/min to a maximum of 45 Microg/min until contraction ceased or side effects started. Continuous maternal and fetal monitoring was carried out in both groups
Results: Fifty patients presenting with preterm labour were studied. The maximum numbers of patients were in the age group of 30-34 years. Mean gestational age in group-I was 30.56weeks and group-II was 30.60weeks. 88% were with cephalic presentation, 8% had breech presentation and 4% presented with transverse lie in both groups. In group-I, 80%cases were < 32weeks of gestation and in group-II, 72% cases were <32 weeks of gestation. 52% in group-I and 56% in group-II were primigravida. Dilatation of the cervix at the time of first examination in group-I was 2cm in 22[88%] patients and 2-4cm in 3[12%] patients. In group-II 2cm in 20[80%] patients and 2-4cm in 5[20%] patients. The effacement of the cervix at the first examination was < 40% in 16 patients [64%]. 40-50 in 6 [24%] patients and 60% in 3 [12%] patients in group-I and in group-II < 40% in 14 [56%] patients, 6[24%] patients 40-50% effacement and 5[20%] patients had 60% effacement. Successful tocolysis was achieved in 76% of the cases with Ritodrine hydrochloride [Group-I] and in 72% of the cases with Salbutamol [Group-II]. The delay in the delivery for 48 hours, 7 days and till 36 weeks of gestation were 76%, 64%, and 52% of patient respectively for Ritodrine and 72%, 56% and 40% respectively for Salbutamol. Headache, nausea and vomiting were complained in 6[24%], 2[8%] and 1[4%] patient in group-I and 4[16], 3[12%], and 2[8%] in group-II respectively
Conclusion: This study shows that Ritodrine hydrochloride and Salbutamol are equally effective regarding delay of delivery and prolongation of gestation
ABSTRACT
Aims and Objectives: To review the efficacy of Sacrocolpopexy in the management of vaginal vault prolapsed
Study Design: Interventional study
Setting and Population: Department of Obstetrics and Gynaecology, Jinnah Hospital, Lahore. Women with vaginal vault prolapse after hysterectomy.
Methods and Main-outcome measures: Abdominal Sacrocolpopexy using proline mesh. Follow-up in these patients were carried out at one week, four weeks, six months, and one year
Results: Sacrocolpopexy was carried out in ten patients for vaginal vault prolapse after vaginal [6] and abdominal hysterectomy [4]. The mean age was 49.8 years. Parity was between P3 - P6 [Mean parity 4.3]. Mean operation time was 79.3 minutes. Estimated blood loss was less than 200m1. No intra-operative or post-operative complications occurred in any case
Conclusion: Abdominal sacrocolpopexy is effective and safe in the treatment of vaginal vault prolapse. This procedure has high success rate in correcting prolapse without a time dependent decrease in efficacy