Hysterectomies; an audit at a tertiary care hospital

To audit indications and histopathological diagnosis of hysterectomies performed at Muhammad Medical College hospital, Mirpurkhas. Retrospective study. Department of Obstetrics and Gynaecology and Department of Pathology, Muhammad Medical College Hospital, Mirpurkhas Sindh from January to December 2008. Data regarding symptoms and indications of hysterectomies performed during this year were collected from files and patient records. Histopathological reports of those patients were collected from department of pathology. The results were analyzed by percentages. A total of 145 hysterectomies were performed in 2008. Mean age of patients was 45years ranging from 35-60 years and parity ranges from 4 - 10. Most common presenting complaints were excessive menstrual blood loss in 97[67%] patients, followed by some thing coming out of vagina 28[19%]. Most common pre-operative diagnosis of fibroid was made in 44 [33%] followed by uterovaginal prolapse in 28[19%] and dysfunctional uterine bleeding [DUB] in 18[12%] of patients. Regarding histopathological diagnosis chronic cervicitis was the most commonly diagnosed pathology in 45 [31%] followed by fibroid in 25[17%] cases. A yearly audit should be conducted in every institute to collect data and to analyze the pattern of indication and lesions found on histopathological examination

Secondary postpartum haemorrhage due to rupture of uterus

We report a very unusual case of secondary postpartum hemorrhage due to uterine rupture. Our case was a 23 years old lady who presented with heavy bleeding per vagina and gave history of home delivery. Rupture was most probably caused by injudicious use of oxytocic injection by a Traditional Birth Attendant at home. Surprisingly, after recovering completely from primary episode she again had heavy blood loss after 5 days. An emergency hysterectomy of the patient was performed to save the life