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

Arora, R; Rajaram, Priyanka; Oumachigui, Asha; Parveena,

doi:10.1111/j.1471-0528.1993.tb15125.x

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…The reported incidence of destructive operations is 0.09-0.26% of all births. 4,5 During the COVID pandemic a change in policy, offering destructive operations to these women was introduced, explaining our increase in incidence (from nil to 0.24%) of destructive operations. 6…”

Section: Discussionmentioning

confidence: 97%

Revisiting destructive operations to prevent second stage caesarean section in COVID times: A case series

et al. 2022

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Destructive operations diminish the bulk of the foetus for facilitating vaginal delivery. Procedures such as craniotomy or decapitation can be carried out to deliver a dead baby in appropriately selected cases. Ours is a retrospective case series at a single tertiary facility during the first wave of the COVID pandemic. From July 2020 to January 2021, six destructive operations (five craniotomies and one decapitation) were performed in women who had arrest of descent in the second stage of labour but had intrapartum foetal demise. The average operative time was 30 minutes with a mean hospital stay of 4.3 days, which was significantly less than CS, and with much less morbidity. None of these women had significant post-partum haemorrhage or sepsis. Destructive procedures should be considered for better obstetric future of the patient, and a lesser burden on the health facility. What was practiced in COVID times should be extended beyond.

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Section: Discussionmentioning

confidence: 97%

Revisiting destructive operations to prevent second stage caesarean section in COVID times: A case series

et al. 2022

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“…8,9 Arora et al from a medical college hospital Pondicherry reported in 1999, 33 destructive operations performed between 1981 and 1991-27 craniotomies, two decapitations, three eviscerations and one cleidotomy. 10 Biswas et al from Kolkata reported a 1.17% (141 in 12,034 deliveries over a year) incidence of obstructed labor-0.29% or 36 with dead fetus. 44.4% underwent craniotomy and 55% evisceration.…”

Section: Destructive Operationsmentioning

confidence: 99%

Role of fetal craniotomy in modern day obstetrics: case series

Xess¹,

Shrivastava²

2019

Int J Reprod Contracept Obstet Gynecol

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Although obstructed labor in vanished from the western world where the destructive operations are obsolete and not needed, in developing countries like India obstructed labor with dead fetus and severe infection is a sad reality, and destructive operations are an essential part of obstetric practice and cannot be wished away. In many situations they should be a preferred option to cesarean delivery which needs much better facilities and greater morbidity. Here authors present a case series of three patients who reported with obstructed labour and IUFD. Fetal craniotomy was done and thus maternal morbidity reduced. Craniotomy offers less postpartum morbidity, lesser expertise and resources and therefore better in cases presenting with obstructed labour and dead baby in developing countries.

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“…37 In some cases that have a poor prognosis, such as hydrocephalus, the tendency to develop dystocia when the head fluid is very massive, resulting in the size of the fetal head tending to enlarge. 38 Vaginal delivery is performed even though it is still premature, and the reference is a measurement of head circumference to avoid the occurrence of pelvic head dysproporsi. 39…”

Section: Dystociamentioning

confidence: 99%

Induced labour in pregnancy with congenital abnormalities: clinical indications or patient demand

Pribadi

2022

Int J Reprod Contracept Obstet Gynecol

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Congenital abnormalities are a nightmare for a pregnant woman. However, congenital abnormalities are divided into several conditions. The state of major disability is the worst situation, with the possibility of disability and even postpartum death. The disability is still a pregnancy that can cause complications that have a bad effect on the mother, so the pregnancy is often induced labor for fear of endangering the mother even though the complications have not yet appeared. In addition, it often happens because the family refuses the presence of a child with a disability. Criteria and references for intrauterine anomalies have been made by various countries and organizations, with the treatment taking into account clinical, psychosocial, religious, and legal aspects. However, this reference is not always easy to implement due to various factors, so that the decision to induced labor or induced abortion is always based on the advice of the medical team and family approval without leaving the legal aspect. Parental consent is important because not all pregnant women agree to induced labor of pregnancy even though it is a major disability and threatens postpartum death. On the other hand, if the defect can be corrected, then a clinician must be able to maintain the pregnancy and refuse unnecessary attempts to terminate the pregnancy.

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

Cited by 7 publications

References 2 publications

Revisiting destructive operations to prevent second stage caesarean section in COVID times: A case series

Revisiting destructive operations to prevent second stage caesarean section in COVID times: A case series

Role of fetal craniotomy in modern day obstetrics: case series

Induced labour in pregnancy with congenital abnormalities: clinical indications or patient demand

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