No abstract

Women with multiple risk factors for cesarean can be taken up for elective cesarean section rather than inducing them at term.

Retrospective study of 121 cases of adnexal masses which were managed laparoscopically was carried out. The aim of study was to evaluate the safety and effectiveness of laparoscopic management of adnexal masses. In 120 cases, procedure was completed safely with minimum morbidity. In one case laparotomy had to be done to complete the procedure. In 76 cases cystectomy was done, 26 required salpingo-oophorectomy and 19 required only salpingectomy. Histologic evaluation revealed 30 functional cysts, 36 endometriotic cysts, 11 dermoids, 9 serous cystadenomas, 3 mucinous cystadenomas, 11 parovarian cysts, 19 cases of hydrosalpinx and 2 cases of tuberculosis.

To compare the laparoscopic approach with laparotomy in the treatment of ectopic pregnancy, a retrospective analysis involving 52 patients with ectopic pregnancies was done. The aim of this study was to evaluate the safety and efficacy of laparoscopic surgery for ectopic pregnancies. 30 patients underwent laparoscopic management while 22 patients were managed by conventional laparotomy. In the laparoscopic group, the postoperative morbidity and post-hospital stay were significantly less. Although laparoscopic surgery for ectopic pregnancies is a new approach and it is not widely practised in service hospitals, it has more advantages than open surgery and it has been well accepted by the surgeons and patients. It is a safe and feasible approach.

The most frequent indication for hysterectomy is menorrhagia, even though the uterus is normal in a large number of patients. Transcervical resection of the endometrium (TCRE) is a less drastic alternative, but success rates have varied and menorrhagia can recur. 60 patients with menorrhagia due to various causes who failed to respond to medical therapy and did not desire pregnancy and hysterectomy underwent TCRE with hysteroscope. 56 cases have been followed up postoperatively for 3 years. The primary endpoints were women's satisfaction and need for further surgery. The proportion of patients who attained amennorhea 24 months after the procedure was 44.4% and the percentage of patients who attained hypomennorhea was 44.4%. The patients satisfaction rate after 24 months of follow up was 88.8%. Failure of TCRE procedure was encountered in 6.6% of patients. Randomized comparison with hysterectomy has shown short-term benefits in the form of shorter operating time, fewer complications and faster rates of recovery and almost as high satisfaction levels. TCRE is an effective procedure in treating menorrhagia and is an acceptable alternative to medical management and hysterectomy in the treatment of menorrhagia for many women with no other serious disorders.