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Titel:	Destructive operations in modern obstetrics in a developing country at tertiary level.
Autor/in / Beteiligte Person:	Arora, R ; Rajaram, P ; Oumachigui, A ; Parveena
Zeitschrift:	British journal of obstetrics and gynaecology, Jg. 100 (1993-10-01), Heft 10, S. 967-8
Veröffentlichung:	Oxford : Blackwell Scientific Publications ; <i>Original Publication</i>: London., 1993
Medientyp:	academicJournal
ISSN:	0306-5456 (print)
DOI:	10.1111/j.1471-0528.1993.tb15125.x
Schlagwort:	Cesarean Section statistics & numerical data Craniotomy statistics & numerical data Female Humans India Morbidity Pregnancy Referral and Consultation Retrospective Studies Developing Countries Obstetrics
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Br J Obstet Gynaecol] 1993 Oct; Vol. 100 (10), pp. 967-8. MeSH Terms: Developing Countries* ; Obstetrics* ; Cesarean Section / statistics & numerical data ; Craniotomy / statistics & numerical data ; Female ; Humans ; India ; Morbidity ; Pregnancy ; Referral and Consultation ; Retrospective Studies Comments: Comment in: Br J Obstet Gynaecol. 1994 Sep;101(9):829-30. (PMID: 7947538) Contributed Indexing: Indexing Agency: PIP Local ID #: 090600. Indexing Agency: POP Local ID #: 00227571. ; Keywords: Asia; Developing Countries; India; Obstetrical Surgery; Research Methodology; Retrospective Studies; Southern Asia; Studies; Surgery; Treatment ; Note: TJ: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. ; Local Abstract: [PIP] In southern India, obstetricians conducted a retrospective study of 33 destructive obstetric operations performed between 1981 and 1991 at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Pondicherry. The mothers were all under 40 years old. The operations included 27 craniotomies, 2 decapitations, 3 eviscerations, and 1 cleidotomy (surgical division of the fetus' clavicle to facilitate delivery). Women with shoulder presentation and hand or cord prolapse tended to arrive at the hospital before full cervical dilatation so obstetricians preferred performing a cesarean section, regardless of viability of the fetus, explaining the low rate of decapitation and evisceration. Yet, obstetricians and primary health center physicians referred most women with cephalic presentation rather late in labor with indications of an important rupture or ruptured uterus. Reasons for craniotomy were hydrocephalus (52%), obstructed labor (19%), arrest of aftercoming head (7%), cord prolapse (5%), persistent meuto-transverse position (4%), and placental abruption (4%). 3 cases had to undergo Cesarean section after other procedures failed. 6% of the women suffered vaginal laceration. 3% experienced fever, urinary tract infection, episiotomy, wound infections, or paralytic ileus. 1 woman died from postpartum hemorrhage and another died from severe postoperative shock after undergoing lower segment cesarean section. The incidence rate of destructive operations was lower than that of other Indian hospitals (all deliveries, .094% vs. .24-.283%). These findings suggested that obstetricians and primary healthy center physicians need to be trained in doing confidentially performed craniotomy, decapitation, or evisceration in rural areas so they do not refer mothers at high risk of ruptured uterus and subsequent death while in transmit to a referral center. Entry Date(s): Date Created: 19931001 Date Completed: 19931214 Latest Revision: 20190719 Update Code: 20231215

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Destructive operations in modern obstetrics in a developing country at tertiary level.