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Assessment of the Cases Undergone Peripartum Hysterectomy in a Tertiary Care Hospital in the Last Three Years  [PDF]
Afroz Sayma, Gulshan Ara
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.811101
Abstract: Background: Emergency peripartum hysterectomy (EPH), although rare in modern obstetrics, remains a life-saving procedure in cases of severe hemorrhage. Objective: To assess the incidence, indications, outcomes & complications of peripartum hysterecomty performed in a tertiary care hospital & compare the results with other reports in the literature. Methods: Twenty nine peripartum hysterectomy cases carried out between July 2015 and June 2018 in Enam Medical College & Hospital, Savar, Dhaka were evaluated retrospectively. Maternal characteristics and characteristics of the present pregnancy and delivery, hysterectomy indications, operative complications, postoperative conditions, and maternal and neonatal outcomes were evaluated. Results
History of caesarean hysterectomy
Spari？ Radmila,Kadija Sa？a,Hudelist Gernot,Gli？i？ Andreja
Acta Chirurgica Iugoslavica , 2012, DOI: 10.2298/aci1201009s
Abstract: Caesarean hysterectomy evolved as a life-saving procedure following caesarean delivery. The concept underlying caesarean hysterectomy dates back to the mid 1700s and with a description of the procedure performed on laboratory animals. Eduardo Porro of Milan performed the first planned caesarean hysterectomy in which both the infant and the mother survived. He documented his operation in a paper published in 1876. Porro advocated hysterectomy combined with caesarean section to control post partum haemorrhage and to prevent infection. The maternal death rate following the operation remained high, but was substantly below the rate prior to the introduction of the procedure. The Porro procedure contributed to more favourable outcome for both the mother and the infant, having sterility and premature menopause as its side effects. Fortunately, the need for the procedure was soon minimised following the proposal to close the uterine incision with sutures. Although elective caesarean hysterectomy is still a controversial issue, there is no doubt that emergency post partum hysterectomy in case of massive obstetric haemorrhage is potentially life-saving. Over the past decades, the availability of potent uterotonics and broad-spectrum antibiotics, the development of embolisation techniques, and new methods of vessel ligation, have markedly reduced the need for caesarean hysterectomy, which, however, remains an important procedure in modern obstetric practice.
Síndrome de Ogilvie poshisterectomía: reporte de un caso y revisión de la literatura
Hernández-Pinzón,Jairo; Castillo-Zamora,Marcos; Rodríguez,Carolina;
Revista Colombiana de Obstetricia y Ginecología , 2009,
Abstract: objective: presenting the workup and management of a pregnant woman who presented ogilvie’s syndrome as a complication of an obstetric hysterectomy and describing the epidemiology, physiopathology and clinical findings following gynecobstetric procedure and treatment of this pathology by means of a literature review. case report: the case of a 28-year-old woman is presented; the patient presented uterine atony following normal vaginal delivery after 38 weeks’ pregnancy. a subtotal abdominal hysterectomy was made due to lack of improvement with medical management. the patient presented fever, intolerance to oral route, tachycardia, distended and hypertympanic abdomen, pain in response to surface and deep palpation of the right hemi-abdomen and decreased peristalsis during postoperative period. the abdominal radiograph revealed obstruction of the small intestine; exploratory laparotomy was thus carried out, showing foetal peritonitis and perforation of the colon at the ileocecal valve without evidence of mechanical obstruction. discussion: ogilvie’s syndrome is characterised by massive and progressive dilatation of the colon in the absence of small bowel obstruction. the syndrome mainly develops in hospitalised patients suffering from severe medical conditions; nonetheless, it also occurs after gynecobstetric procedures. because this syndrome is associated with high rates of morbidity andmortality,thegynecobstetricianmustrecognise this syndrome as being a possible complication of gynecobstetric procedure.
Caesarean Myomectomy in a Nullipara Following In Vitro Fertilization Pregnancy: A Case Report  [PDF]
Kenneth Chinedu Ekwedigwe, Chinekwu Somtochukwu Ugwuoke, Chinenye Eunice Okonkwo, Kester Eluemunor Nwaefulu, Luciana Chiamaka Anyanwu, Jane Nkemjika Ugwu, Promise Chioma Nsiegbunam, Ifeanyi Paul Ekwedigwe, Martha Chilee Ekwedigwe, Goodluck Munachimso Ekwedigwe
Open Journal of Obstetrics and Gynecology (OJOG) , 2026, DOI: 10.4236/ojog.2026.161014
Abstract: Background: Caesarean myomectomy is the surgical removal of a leiomyoma during a caesarean section. The surgical removal of leiomyoma during caesarean section is controversial and is often avoided because of increased vascularity of the gravid uterus which leads to significant blood loss, needless hysterectomy and increased perioperative morbidity and mortality. Case Presentation: A 41-year-old gravida 3 para 0 + 2 with in vitro fertilization pregnancy who presented at 34 weeks + 1 day gestation for elective caesarean section. She has a history of myomectomy. Abdominopelvic ultrasound scan showed active twin gestation with a submucous fibroid measuring 4 × 3 cm located anteroinferiorly. Patient had anemia which was corrected and subsequently had caesarean section. During the procedure the submucous myoma was encountered at the line of incision at left lateral side and was removed. She developed post-partum preeclampsia and was managed. She also received 2 units of blood post-surgery following a post-surgery packed cell volume of 20%. She was subsequently discharged after 3 days post-surgery and sutures were removed on day 10 post-surgery. There were no complications. Conclusion: Caesarean myomectomy remains debatable. However, following careful surgical planning, selected cases can be done by experienced surgeons equipped to handle peri-operative complications should they arise.
Caesarean Scar Ectopic Pregnancies—Case Series from a District General Hospital  [PDF]
Folasade Akhanoba, Alero Awala, Tony Boret
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.75063
Abstract: Caesarean Scar Ectopic Pregnancy (CSEP) is a rare, but potentially catastrophic complication of a previous Caesarean Section (CS) birth. This is a review of 5 cases of CSEP managed in our Early Pregnancy Unit at Watford General Hospital within a 10-month period. Two patients had only one previous CS, whilst 2 had two and the last had 3 previous CS. All our patients presented within the first trimester of pregnancy (range 6 to 11 weeks’ gestation) with light vaginal bleeding; 4 of them had associated mild to moderate abdominal pain. All were diagnosed using transvaginal ultrasound scan. Three of our patients were managed surgically by Suction Evacuation under Ultrasound guidance and insertion of a Foley’s catheter prophylactically for tamponade in order to reduce blood loss both intra- and post-operatively. One of our patients had a heterotopic pregnancy with a viable intrauterine pregnancy and a live CSEP. She declined any intervention so she was managed conservatively with weekly Consultant appointments and scans. There was a subsequent demise of the CSEP and she continued with a singleton pregnancy. None of our patients were managed medically. There is no absolute consensus on diagnostic criteria and there is no standard management protocol so each woman should be given all the available information and the opportunity to decide on the management of her pregnancy. The risk of a CSEP in a subsequent pregnancy should be part of the consent process for CS.
Scar Endometriosis—Case Report  [PDF]
Atif Bashir E. Fazari, Litty Paulose, Sadia Maqbool, Zoiya Fatima Malik, Lakshmiah Raman
Open Journal of Obstetrics and Gynecology (OJOG) , 2018, DOI: 10.4236/ojog.2018.812122
Abstract: Endometriosis is one of the common gynecological disorders in women of reproductive age group. Extra pelvic endometriosis is rare and the most common sites are bladder, gastrointestinal tract, lungs, under the skin especially after obstetric surgical interventions. Total surgical excision is the best option for diagnosis and treatment.
Analysis of the Caesarean Section Rate in Armenia for the Period 2016-2021 Based on the Results of a Single Center Study  [PDF]
Norayr Nver Ghukasyan
Open Journal of Obstetrics and Gynecology (OJOG) , 2023, DOI: 10.4236/ojog.2023.131005
Abstract: Background: The caesarean section rate is an important factor that characterizes the effectiveness of the obstetric service. The large variability of the initial state of women in labor and the variety of indications for surgery does not allow us to identify the main determinants. We attempted to determine and analyzed the first data on the structure and frequency of caesarean section in Armenia in the hospital of the Erebоuni multidisciplinary clinic before the introduction of the M. Robson scale. Methodology: We conducted a retrospective study of the history of childbirth in 38,111 patients registered at the Erebouni Medical Center for the period 2016-2021. The materials of the study were case histories, hospitalization materials and annual reports. Results: According to the obtained data, 80.5% of caesarean section operations were performed as planned. Only 14% of pregnant women were delivered by caesarean section according to absolute indications, the frequency of that in this maternity hospital increased from 36.77% to 44.95% over the analyzed period Conclusion: Thorough psychoprophylactic preparation of pregnant women for childbirth, including those with a scar
Síndrome de Ogilvie poshisterectomía: reporte de un caso y revisión de la literatura Ogilvie's syndrome post hysterectomy: a case report and literature review
Jairo Hernández-Pinzón,Marcos Castillo-Zamora,Carolina Rodríguez
Revista Colombiana de Obstetricia y Ginecología , 2009,
Abstract: Objetivo: presentar el estudio y el tratamiento que se le realizó a una mujer embarazada que presentó Síndrome de Ogilvie (SO) como complicación de una histerectomía obstétrica, así como describir la epidemiología,la fisiopatología, los hallazgos clínicos después de los procedimientos gineco-obstétricos y el tratamiento de esta patología mediante una revisión de la literatura. Presentación del caso: mujer de 28 a os de edad con embarazo de 38 semanas de gestación quien después de parto vaginal eutócico sufrió atonía uterina. Debido a la falta de mejoría con el manejo médico, se le realizó una histerectomía abdominal subtotal, presentando picos febriles, intolerancia a la vía oral, taquicardia, distensión e hipertimpanismo abdominal con dolor a la palpación superficial y profunda en hemiabdomen derecho y peristaltismo disminuido durante el posoperatorio. La radiografía de abdomen evidenció un cuadro obstructivo con origen probable a nivel del intestino delgado, por lo que se le practicó una laparotomía exploratoria donde se le encontró peritonitis fecal y perforación colónica a nivel de la válvula ileocecal, sin evidencia de obstrucción mecánica. Discusión: el SO se caracteriza por la dilatación masiva y progresiva del colon en ausencia de una obstrucción mecánica. Se desarrolla principalmente en pacientes hospitalizadas con graves condiciones médico-quirúrgicas, pero también se presenta frecuentemente después de procedimientos gineco-obstétricos. Debido a que este síndrome se ha visto asociado con una alta morbimortalidad, es necesario que el gineco-obstetra lo tenga en cuenta como diagnóstico diferencial y esté atento a su presentación como complicación de cirugías obstétricas o ginecológicas. Objective: presenting the workup and management of a pregnant woman who presented Ogilvie’s syndrome as a complication of an obstetric hysterectomy and describing the epidemiology, physiopathology and clinical findings following gynecobstetric procedure and treatment of this pathology by means of a literature review. Case report: the case of a 28-year-old woman is presented; the patient presented uterine atony following normal vaginal delivery after 38 weeks’ pregnancy. A subtotal abdominal hysterectomy was made due to lack of improvement with medical management. The patient presented fever, intolerance to oral route, tachycardia, distended and hypertympanic abdomen, pain in response to surface and deep palpation of the right hemi-abdomen and decreased peristalsis during postoperative period. The abdominal radiograph revealed obstruction of the small intestine; e
Impact of Age on Surgical Outcomes after Robot Assisted Laparoscopic Hysterectomies  [PDF]
A. Eddib, S. Hughes, M. Aalto, A. Eswar, M. Erk, C. Michalik, V. Krovi, P. Singhal
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.53018
Abstract:

Objective: To estimate the impact of patient’s age on surgical outcomes in patients undergoing robotic hysterectomy. Methods: A retrospective review of prospectively collected cohort data for a consecutive series of patients undergoing gynecologic robotic surgery. Patient’s age and perioperative variables were collected from the database, charts, and other hospital records of all patients undergoing robotic hysterectomy. Results: 399 patients underwent robotic surgery for gynecologic disease. 370 patients who were under age 70 were compared with 29 patients who were over age 70. When comparing all patients under age 70 with patients over age 70, the mean age was 48.4 and 77 (P < 0.05), mean BMI was 32.1 and 28.3 kg/m2 (P < 0.05), mean procedure time was 185 and 211 minutes (min) (P = 0.09), mean console time was 123 and 148 min (P = 0.056), mean OR (Operating room) time was 237 and 273, mean EBL (Estimated blood loss) was 71 and 65 ml (P = 0.74), Hb (Hemoglobin) drop was 1.4 and 1.2 (P = 0.45), uterine weight was 212 and 95 gm (P = 0.98), and length of stay was 1.4 and 1.6 days (P = 0.33) (Table 1). The patients over age 70, when procedures were combined, had a statistically significant lower mean BMI, uterine weight and longer Operating room (OR) time. However, when stratified by the type of procedure performed, there was no difference in surgery times among those under 70 and over 70 years of age. The elderly patients were more likely to have cancer, which was in almost half the elderly patients, and thus necessitate staging. Thus adding the performance of lymph node dissection likely resulted in the increased length of the surgery time that was noted in the combined group (Tables 1,

A Retrospective Review: Vaginal versus Abdominal Hysterectomy for Benign Gynecological Diseases in a Tertiary Canter  [PDF]
Lujain Bukhari, Ayman A. Bukhari, Omar F. Albakri, Arwa F. Alshamrani, Walaa E. Alahmadi, Hassan S. O. Abduljabbar
Open Journal of Obstetrics and Gynecology (OJOG) , 2016, DOI: 10.4236/ojog.2016.612094
Abstract: The aims are to review respectively 229 cases of hysterectomy and to find the factor affecting the decision of vaginal hysterectomy. Data collected from medical charts include age, nationality, parity, menopause, history of Dilation and curettage. The following data were obtained: the clinical presentation and the indication for hysterectomy. Postoperative complication includes the estimated blood loss, the number of days in hospital and ICU admission recorded. The route of hysterectomy found that 187 (82%) were abdominal and only 42 (18%) were vaginal. Factors significantly associated with the choice of vaginal approach: age, parity, smaller uterine size and prolapse. Factors affecting the decision of vaginal hysterectomy for treatment of benign diseases are identified as follows: if the age is more than 35 years or if the women already reach menopause, the presenting symptoms are not vaginal bleeding but prolapsed uterus and uterine size is less than 12 weeks.
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