RESUMO
Background: Peripartum or obstetric hysterectomy is the removal of the corpus uteri alone or with the cervix at the time of a caesarean section or shortly after a vaginal delivery. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times it is a very difficult decision and requires good clinical judgment. Most of the time the operation is carried out when the condition of patient is too critical to withstand the risks of anesthesia or surgery, but proper timing and meticulous care may reduce or prevent maternal complications.Methods: The study is prospective study and was conducted on cases of peripartum emergency hysterectomy performed at PDZH, Udaipur, during the period from April 2021 to October 2022.Results: Our study depicts following results on the basis of 31498 deliveries during the study period (April 2021 to October 2022), so the overall incidence of peripartum hysterectomy is 1 in 1049 (0.095%). Incidence of hysterectomy following vaginal delivery found to be 0.15%, whereas following caesarean incidence found to be 0.24%.Conclusions: Increase in caesarean section rates may lead to a rise in the number of peripartum hysterectomies required in the future because of increased chances of scar dehiscence and morbidly adherent placenta and Thus, there is a need for institutions to reassess their indication for first caesarean section to decrease the incidence of caesarean sections.
RESUMO
Background: Twin pregnancy refers to the presence of two fetuses in the uterus. The phenomenon of twinning has fascinated mankind throughout its recorded history. The major problems occurring in twin pregnancy are prematurity, Lbw, IUGR, birth trauma, birth asphyxia and congenital anomalies. The most serious risk is preterm delivery, which accounts for most of the increased perinatal mortality, neonatal morbidity, and long-term morbidity of twins.Methods: This prospective observational study included analysis of 250 women with twin pregnancies, over a period from 01st November 2021 to 31st October 2022 with 28 completed weeks of gestation, admitted at PDMC, Udaipur, Rajasthan.Results: In our study 250 twin pregnancies delivered Out of total 15209 deliveries were studied in our institute. incidence of twin pregnancy was 1.64%. The majority of study participants were in the age group 20 to 29 year and delivered between the gestation age 34-37week, multigravida was 51.2% and in primi it was 48.8%. The 4% patients underwent caesarean section and 48% delivered by vaginal delivery.Conclusions: Twin pregnancy is a great challenge to the concerned obstetricians. Complications associated with twin pregnancies cannot be prevented but can be detected early and controlled adequately by proper and prompt management. Timely diagnosis and treatment of nutritional anaemia and pre-eclampsia helps in preventing additional complications. Hence the need for better obstetric care, neonatal care, health services to get a better fruitful outcome.