"Peripartum Hysterectomy: Impact on Reproductive Health and Safety"
Journal name: World Journal of Pharmaceutical Research
Original article title: “peripartum hysterectomy - a limiting factor for procreative potential & safe-motherhood”; a 5 years retrospective study.
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Original source:
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Dr. U. Agnes Vijaya, Dr. Anusha Patel, Purushothama Reddy. K, Mallesh. M and A. Nagaraj
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: “peripartum hysterectomy - a limiting factor for procreative potential & safe-motherhood”; a 5 years retrospective study.
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Copyright (license): WJPR: All rights reserved
Summary of article contents:
Introduction
Peripartum hysterectomy refers to the surgical removal of the uterus either during an emergency procedure within 24 hours following childbirth or electively when necessary. This study, conducted over a five-year period at the Rajiv Gandhi Institute of Medical Sciences in Kadapa, YSR district, Andhra Pradesh, South India, aimed to analyze the incidence, risk factors, complications, and outcomes associated with peripartum hysterectomy, shedding light on its implications for maternal health and childbearing potential.
Causes and Incidence of Peripartum Hysterectomy
In the reviewed cases, the incidence of peripartum hysterectomy was found to be 1.3 per 1000 deliveries, with the most significant indication being uterine rupture, discovered in 54.8% of the cases. Other causes included uterine atony, abnormal placentation, and specific conditions like Couvelaire uterus and ectopic pregnancy. The study revealed that many women (71.4%) were multigravidae, with a notable proportion of cases occurring at night, indicating the urgency associated with the procedure.
Risk Factors and Socio-Demographic Considerations
The study identified several risk factors contributing to the need for peripartum hysterectomy. Critical socio-demographic factors included low literacy levels, early marriage, socioeconomic deprivation, and a desire for larger families. Additionally, previous cesarean sections and prolonged or obstructed labor were highlighted as significant risks. Effective maternal and child health services were deemed essential in addressing these risk factors and improving outcomes.
Maternal and Perinatal Outcomes
The maternal outcomes analyzed revealed that postpartum complications such as bladder repair and wound infections occurred, with a noted maternal mortality rate of 4.8%. Perinatal outcomes were concerning, with 38% of infants experiencing perinatal mortality, including cases of intrauterine death and stillbirths. These outcomes reflect the high risks associated with peripartum hysterectomy, emphasizing the procedure's life-saving nature even amidst significant maternal and fetal risk.
Conclusion
The findings of the study underscore the pressing need for improved maternal care services to mitigate the risks associated with peripartum hysterectomy. With rupture uterus being the leading cause, enhancing skills in managing labor complications, addressing socio-economic challenges, and ensuring access to skilled healthcare are critical to reducing the incidence of this procedure. To uphold safe motherhood and preserve women's reproductive potential, effective maternal healthcare programs must be prioritized, particularly in resource-limited settings like India.
FAQ section (important questions/answers):
What is peripartum hysterectomy and why is it performed?
Peripartum hysterectomy is the surgical removal of the uterus performed within 24 hours following childbirth. It is primarily conducted as an emergency life-saving measure in cases of severe complications such as uterine rupture or abnormal placentation.
What was the objective of the study conducted at RIMS, Kadapa?
The study aimed to evaluate the incidence of peripartum hysterectomy, analyze its causes, risk factors, and the associated maternal and fetal morbidity and mortality over a five-year period at Rajiv Gandhi Institute of Medical Sciences.
What were the common causes of peripartum hysterectomy identified in the study?
The leading causes identified included uterine rupture (54.8%), uterine atony (26.2%), and abnormal placentation (9.6%). These factors were significant contributors to the need for emergency hysterectomy in the surveyed population.
What demographic factors were associated with a higher incidence of peripartum hysterectomy?
Risk factors included low literacy levels, early marriages, socioeconomic deprivation, and a desire for larger families. These social determinants were significant predictors of complications requiring hysterectomy during childbirth.
How many cases of peripartum hysterectomy were studied in the research?
The study reviewed 42 cases of peripartum hysterectomy conducted among 32,398 deliveries over five years, highlighting an incidence of 1.3 per 1000 deliveries.
What recommendations were made to reduce the incidence of peripartum hysterectomy?
The study recommended improved maternal and child health services, better access to skilled birth attendance, timely interventions in prolonged labor, and effective family planning measures to mitigate the risks associated with childbirth.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “"Peripartum Hysterectomy: Impact on Reproductive Health and Safety"”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Vijaya:
Vijaya refers to Dr. U. Agnes Vijaya, the primary author of the study 'Peripartum Hysterectomy.' Her expertise in obstetrics and gynecology anchors the research, emphasizing the challenges of maternal health in the context of emergency peripartum hysterectomy, thus underscoring the importance of skilled medical professionals in healthcare settings.
2) India:
India, as the geographical context of the study, highlights the challenges faced by the healthcare system in a developing country. The study examines peripartum hysterectomies, which are prevalent in India, due to various socio-economic factors, and the necessity for improved maternal health services in such regions.
3) Study (Studying):
The term 'study' encapsulates the retrospective analysis undertaken by the researchers, which investigates the incidence, causes, and outcomes of peripartum hysterectomies over a five-year period. It serves to contribute to existing medical knowledge and inform health policies aimed at reducing maternal and perinatal mortality.
4) Table:
The 'Table' format within the research presents data clearly and concisely, allowing readers to grasp critical statistical findings regarding cases, age groups, causes, and outcomes. Tables enhance comprehension and facilitate comparisons in epidemiological studies, aiding health professionals in identifying patterns and guiding clinical decisions.
5) Kadapa:
Kadapa is the location of the Rajiv Gandhi Institute of Medical Sciences, where the study was conducted. The relevance of Kadapa surfaces through its representation of regional healthcare challenges in India, elucidating the specific conditions under which peripartum hysterectomy practices occur within a tertiary care setting.
6) Life:
Life is a central theme in discussions around peripartum hysterectomy, as the procedure is often performed as a life-saving measure in critical obstetric situations. The implications on women's ability to bear children and overall reproductive health underscore the balance between preserving life and managing severe complications.
7) Developing:
The term 'developing' refers to countries with emerging economies facing unique health challenges, including inadequate maternal health services. The study focuses on the factors leading to high rates of peripartum hysterectomy in developing nations, advocating for enhanced medical care to improve outcomes for mothers and infants.
8) Andhra (Amdhra):
Andhra references Andhra Pradesh, the southern Indian state where the research took place. This geographical specification highlights the regional healthcare framework, cultural practices, and socio-economic factors that influence maternal health, thereby providing a localized understanding of the incidence and management of peripartum hysterectomy.
9) Family:
Family plays a crucial role in the context of maternal health, particularly concerning childbirth care practices, cultural expectations, and support systems. The desire for larger families and lack of effective family planning contribute to complications during childbirth, thereby affecting the rates of emergency procedures like hysterectomy.
10) Repair:
Repair refers to the surgical interventions carried out following complications such as uterine rupture or trauma during childbirth. The study discusses the importance of timely and effective repairs to manage serious obstetric emergencies while considering the implications they have for maternal morbidity and future pregnancies.
11) Labour (Labor):
Labour, the process of childbirth, is critical to the context of the study, as complications during labour can lead to emergency situations warranting peripartum hysterectomy. Understanding the dynamics of labour, including prolonged or obstructed labour, is essential for preventing such life-threatening conditions for mothers.
12) Death:
Death pertains to maternal and perinatal mortality associated with severe complications such as hemorrhage during childbirth. The study emphasizes the dire need for effective medical interventions to avert maternal deaths and the implications for families, public health, and healthcare systems in developing regions.
13) Cancer:
Cancer is relevant concerning the risks tied to reproductive health, particularly for women undergoing hysterectomies. Although not the primary focus of this study, the retained cervix in subtotal hysterectomy poses risks for cervical cancer, highlighting the necessity for vigilant follow-up care and preventive measures in women's health.
14) Blood:
Blood is central to understanding the complications of childbirth, particularly in reference to blood loss during emergencies such as peripartum hysterectomy. The management of blood transfusions and addressing hemorrhagic complications are critical components of the study, as they directly influence maternal survival and recovery.
15) Depression:
Depression is a psychological outcome that can follow traumatic childbirth experiences and unforeseen surgeries. The study hints at the emotional and mental health implications for women following a peripartum hysterectomy, emphasizing the importance of providing comprehensive postpartum care that includes mental health support.
16) Teaching:
Teaching refers to the educational efforts in improving healthcare practices, especially in obstetrics. The study serves as a teaching tool for healthcare professionals, highlighting the need for informed decision-making in high-risk deliveries and advocating for practical training in managing obstetric emergencies.
17) Birth:
Birth is the fundamental event around which the study revolves, focusing on the complications that can arise during delivery that necessitate surgical interventions like hysterectomy. Emphasizing safe childbirth practices is essential for improving maternal outcomes and reducing the need for extreme measures.
18) Rami:
Rami pertains to the Rami Reddy Memorial College of Pharmacy associated with the study's authors, representing the interdisciplinary collaboration that exists between obstetricians and pharmacists in improving maternal care. This collaboration can enhance the management of complications through proper medication protocols and guidance.
19) Post:
Post refers to the period following childbirth, which is critical for monitoring maternal health and identifying complications. The study examines the postoperative outcomes of women who underwent hysterectomy, shedding light on the importance of follow-up care to enhance recovery and ensure future reproductive health.
20) Purushottama (Purusottama, Purusha-uttama):
Purushothama Reddy K, one of the co-authors, exemplifies the collaborative nature of the research. His involvement signifies the importance of multidisciplinary approaches in addressing complex maternal health issues, combining perspectives from different medical fields to provide comprehensive insights into challenges faced during childbirth.
21) Performance:
Performance in this context refers to the effectiveness of maternal healthcare services, including management of complications during pregnancy and childbirth. The study critiques the performance of health systems in delivering timely, skilled care to prevent situations necessitating surgical interventions like peripartum hysterectomy.
22) Observation:
Observation refers to the careful monitoring and assessment of cases leading to peripartum hysterectomy. The study highlights the need for healthcare professionals to observe clinical progress during labor, facilitating timely interventions that could prevent severe outcomes for mothers experiencing complications.
23) Discussion:
Discussion encompasses the analysis of findings in the study regarding the incidence, causes, and outcomes of peripartum hysterectomy. It serves as a platform for interpreting data, exploring implications for clinical practice, and suggesting improvements in maternal healthcare to reduce emergencies related to childbirth.
24) Practising (Practicing):
Practicing is a crucial aspect of healthcare, indicating the need for adherence to established clinical guidelines and protocols in obstetric care. The study emphasizes practicing preventive measures effectively to reduce complications during childbirth and thereby minimize the incidence of peripartum hysterectomy.
25) Evolution:
Evolution reflects the advancements in medical practices and surgical techniques concerning obstetric care. The study references the evolution of peripartum hysterectomy procedures, illustrating ongoing improvements aimed at enhancing maternal health outcomes and reducing risks associated with childbirth in emergency scenarios.
26) Medicine:
Medicine is the overarching field within which this study is framed, emphasizing the importance of healthcare delivery, interventions, and research in obstetrics. The findings contribute to evidence-based practices that can lead to improvements in maternal care, highlighting the significance of ongoing medical research.
27) Marriage:
Marriage can impact maternal health dynamics, particularly regarding age at first pregnancy and family planning. The study acknowledges socio-cultural influences on childbirth practices, emphasizing the need for education on reproductive health to counteract factors contributing to increased peripartum hysterectomy incidences.
28) Incision:
Incision references surgical procedures involved in hysterectomy, particularly during emergencies. The type and timing of surgical incisions are critical factors influencing outcomes, and the study underscores the importance of skilled surgical practices in managing severe obstetric complications effectively.
29) Science (Scientific):
Science signifies the methodical approach employed in the study, utilizing data analysis to understand maternal health issues collaboratively. It illustrates the application of scientific methods in obstetrics to yield relevant insights that can inform healthcare practices and improve outcomes for women experiencing childbirth complications.
30) Reason:
Reason pertains to the causative factors identified for necessitating peripartum hysterectomy. The study aims to elucidate the reasons behind such emergency interventions, enabling healthcare professionals to address the root causes and implement strategies to mitigate these risks in maternal healthcare.
31) Desire:
Desire in this context refers to the aspirations women and families have regarding childbirth and family size. Understanding these desires aids healthcare providers in offering appropriate guidance and services to manage reproductive health effectively, ultimately impacting perinatal outcomes and maternal health.
32) Gupta:
Gupta highlights the collaborative nature of the research through the involvement of co-authors. This name signifies the importance of teamwork in addressing maternal health challenges, reinforcing the idea that interdisciplinary approaches are vital for understanding and improving outcomes in obstetric care.
33) Patel:
Patel is another co-author involved in the study, representing the collaborative framework of the research team. This underscores the multi-faceted approaches necessary in maternal health studies, where contributions from different medical backgrounds enrich the understanding of complex healthcare issues surrounding childbirth.
34) Sah:
Shah, also a contributing co-author, signifies the essential nature of collective expertise in addressing the challenges associated with peripartum hysterectomy. The involvement of diverse professionals in research studies enhances the rigor and applicability of findings in clinical practice.
35) Pain:
Pain is a significant concern in the context of childbirth and subsequent surgical interventions. The study implicitly addresses pain management post-hysterectomy, highlighting the need for adequate support and care to alleviate physical and psychological discomfort for women after such traumatic experiences.
Other Science Concepts:
Discover the significance of concepts within the article: ‘"Peripartum Hysterectomy: Impact on Reproductive Health and Safety"’. Further sources in the context of Science might help you critically compare this page with similair documents:
Systematic analysis, Developing countries, Morbidity and Mortality, Menstrual irregularities, Research article, Systematic Review, Retrospective study, Socio-demographic factors, Medical management, Vaginal delivery, Maternal mortality, Postpartum hemorrhage, Maternal outcome, Maternal Death, Perinatal outcome, Safe motherhood, Tertiary Care Teaching Hospital, Maternal and perinatal outcome, Peripartum hysterectomy, Major elective gynecological surgery, Maternal life saving measure, Feto-maternal morbidity, High perinatal mortality, Rupture uterus, Emergency Obstetric Hysterectomy, Abnormal placentation, Uterine atony, Conservative measures, Incidence of peripartum hysterectomy, Gravid status wise distribution, Timing impact on EPH, Complications of hysterectomy, Family welfare methods, Conservative procedures, Total hysterectomy, Obstetrical hysterectomy, Feto-maternal mortality, Emergency causes for EPH, Elective indicated causes, Procreative potential, Perinatal outcome evaluated, Gynaecological surgery, Emergency medical intervention, Didelphy Uterus with Torsion, Risk Factors Identified, Low levels of literacy, Marriage at an early age, Socioeconomic deprivation, Low prevalence of contraceptive use, Ineffective performance of MCH services, Prior LSCS, Multi gravida with prolonged labour, Low lying placentation, Failed conservative medical measures, Failed interventions, Inability to carry out skilled procedures, Conservative measures done, Medical management for PPH, Laparotomy for rupture uterus, Caesarean hysterectomy, Chronic ectopic pregnancy, Subtotal hysterectomy, Cervical stump cancer, Screen cervical cancer, Status of living children, Emergency peripartum hysterectomy, Rupture of the uterus, Placenta's pathologies, Grand multiparity, Low socioeconomic class, Unbooked cases, Case fatality, MCH services, Global causes, WHO systematic analysis, Trends in postpartum hemorrhage, Maternal near miss, Cesarean hysterectomy, Aust N Z J Public Health, Clin Obstet Gynecol, Lancet Glob Health.