ABSTRACT
Objective: to detect and manage vaginal vault hematoma following abdominal and vaginal hysterectomy
Study design: descriptive case series
Place and Duration of study: department of Obstetrics and Gynaecology Unit-1, Bahawal Victoria Hospital/Quaid-e-Azam Medical College Bahawalpur, From January 2009 to December 2013
Methodology: during the period 921 women underwent hysterectomy, 276 through vaginal and 645 through abdominal approach. Patients were scanned on 1[st] and 3[rd] postoperative day. A transabdominal scan was done in patients who underwent vaginal hysterectomy and a transvaginal scan was done for those who had undergone abdominal hysterectomy. The findings were used to relate the postoperative morbidity in cases of vault hematoma
Results: of the total 921 hysterectomies during the study period overall frequency of vault hematoma was 5.32% [n=49]. It was 2.89% [n=8/276] in with vaginal hysterectomy and 6.35% [n=41/645] in abdominal hysterectomy. The most common presenting symptom in postoperative period was unexplained fever [n=23/82 - 28%] in abdominal hysterectomies. In vaginal hysterectomies most of the patients were diagnosed by presence of collection on rescan [n=8/21 - 38%]. Majority of patients in vaginal hysterectomy group were managed conservatively and only 25% underwent colpotomy. In abdominal hysterectomies hematomas were mostly [78%] drained by colpotomy
Conclusion: ultrasonography to detect postoperative hematomas on 3[rd] postoperative day following hysterectomy identified high risk group of patients who need further management or follow up before discharge
ABSTRACT
To determine the risk factors associated with hepatitis B and C carriers versus healthy pregnant women. It was a single center based, cross sectional comparative study, conducted at Gynae ward II, B-V hospital Bahawalpur. Duration of study was from March to August 2008. 100 patients were enrolled in the two groups, 50 HbsAg/Anti HCV positive women [cases] to compare with 50 healthy women [controls] match for parity. The data were recorded on a proforma. 100 pregnant women were enrolled. Sixty eight [68.0%] were aged 25 years or less with a mean age +/- S.D of 24.62 +/- 3.40. Ten [20%] women had HBV and 40[80%] were HCV positive. The risk factors were compared between the two groups by uni-variate and multivariate analysis which showed that history of dental treatment, blood transfusion, surgery, parenteral treatment and jaundice were significant risk factors for hepatitis B and C carrier status. There appears to be a strong co-relation of history of blood transfusion and dental treatment with HbsAg/ Anti HCV carrier state in pregnant women. The anti HCV seropositivity was appreciably high [80%] as compared to HbsAg [20%] in carrier pregnant women