A Low-Fidelity Total Abdominal Hysterectomy Teaching Model for Obstetrics and Gynecology Residents

Author(s):  
Alfred Hong ◽  
Patrick M. Mullin ◽  
Laila Al-Marayati ◽  
Sarah E. Peyre ◽  
Laila Muderspach ◽  
...  
2016 ◽  
Vol 34 (1) ◽  
pp. 9-14
Author(s):  
Ferdousi Chowdhury ◽  
Sayeba Akhter ◽  
Aminul Islam ◽  
Junnu Rayen ◽  
Nayeema Begum ◽  
...  

Background: Blood transfusion is a life saving intervention in some obstetric and gynecological cases but is associated with risk of transfusion reaction and transmission of infection . Appropriate use of blood and blood products is of utmost importance for the safety of the patients. During the evaluation of an ongoing study on PPH,it appears that rate of blood transfusion is unexpectedly high in this centre, which raised the inquisitiveness in evaluating the rate and rationality of blood transfusion in present practice.Objective : To determine the incidence of blood transfusion in admitted and operated cases and is also to evaluate the indication of transfusion among the study patients. Subject and Method: It was an observational descriptive study, conducted from 1st April 2012 to 30th June 2012 in department of obstetrics and gynecology of Ad-din Women Medical College Hospital , Dhaka . Total 256 cases were included for the study, who received blood and /or blood products during the study period.Results: Transfusion rate in total admitted patients was 9.23% . Most common indication for blood transfusion in obstetric patients was mild preoperative anaemia with or without excessive bleeding during cesarean section (63.92%) and second common cause was antenatal anaemia (24.05%). In gynecological cases abortion (45.91%) was the commonest indication for blood transfusion and next common conditions were total abdominal hysterectomy (20.40%),vaginal hysterectomy (7.14%), ectopic pregnancy and post coital tear (6.12%) and( 6.12%).Conclusion: In this study it was observed that, blood transfusion was not appropriate in all cases, specially in cases where single unit blood was transfused . So creation of awareness among the junior doctors, obstetricians, nurses – midwives is essential by developing regular education and training programme.J Bangladesh Coll Phys Surg 2016; 34(1): 9-14


2021 ◽  
Vol 14 (2) ◽  
pp. e238945
Author(s):  
Olga Triantafyllidou ◽  
Stavroula Kastora ◽  
Irini Messini ◽  
Dimitrios Kalampokis

Subinvolution of placental sites (SPSs) is a rare but severe cause of secondary postpartum haemorrhage (PPH). SPS is characterised by the abnormal persistence of large, dilated, superficially modified spiral arteries in the absence of retained products of conception. It is an important cause of morbidity and mortality of young women. In this study, we present a case of secondary PPH in a young woman after uncomplicated caesarean delivery who was deemed clinically unstable, and finally, underwent emergent total abdominal hysterectomy. We reviewed the literature with an emphasis on the pathophysiology of this situation. Treatment of patients with SPS includes conservative medical therapy, hysterectomy and fertility-sparing percutaneous embolotherapy.


Author(s):  
Sunanda N.

Although leiomyomas are the most common pelvic tumors presenting in the reproductive age group, cervical fibroids are rare accounting for 2% of all uterine fibroids. We report a case of 40 year old lady presenting with a firm, non-tender mass of 22-24 weeks size pregnant uterus with restricted mobility. Laparotomy showed a large mass arising from the anterior lip of cervix, with a small uterus pushed posteriorly. Enucleation followed by total abdominal hysterectomy was done. Large cervical fibroids are rare, presenting with surgical difficulties. Careful dissection by expert hands is needed in the management of such cases. 


1996 ◽  
Vol 14 (2) ◽  
pp. 68-70 ◽  
Author(s):  
J Andrzejowski ◽  
D Woodward

The efficacy of acupressure and acupuncture at the Pericardium 6 (PC.6) point in relieving post-operative nausea and vomiting (PONV) is well known. Lengthy manual stimulation of the needles, or electrostimulation, is inconvenient and incurs extra costs. The aim of this study was to test the effectiveness of the antiemetic action of semi-permanent acupuncture needles (SPANs), a cheap and convenient method of administering acupuncture, in the first 48 hours following gynaecological surgery. Patients (n = 36) having total abdominal hysterectomy were studied in a randomised, placebo controlled trial. Study group patients had SPANs inserted in PC.6 on both wrists. The control group had SPANs inserted into sham points on their forearms. There was no difference in the median nausea scores between the groups; however six patients suffered moderate or severe nausea during the second 24 hours in the control group, with none in the study group (p < 0.05). In addition, the nausea score between 8 and 24 hours in patients who had previously experienced PONV, was lower in the study group (median score 2) compared to the control group (median score 4) (p < 0.05). We conclude that the use of SPANs does not reduce the overall incidence of nausea and vomiting but does appear to reduce the severity of nausea in the second 24 hours, and has a greater effect on patients who had had nausea and vomiting after a previous anaesthetic.


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