Gynaecological Emergencies in the Tropics: Recent Advances in Management

Fawole, Adeniran O.; Awonuga, DO

doi:10.4314/aipm.v5i1.63539

Cited by 16 publications

(36 citation statements)

References 33 publications

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“…The low incidence may be related to the shame and secrecy attached to the condition which makes most cases to linger in silence and only a few severe cases and those due to rape report to the hospital for medical help [1,8,10]. An average of 30 cases and 32 cases are seen per year in Senegal and United States respectively [11].…”

Section: Discussionmentioning

confidence: 99%

Consensual Coital Lacerations: A Case Series

Tia¹,

Nf²,

Pe³

2017

Gynecol Obstet Case Rep

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Consensual coital lacerations are commonly encountered in clinical practice. Though not as common as lacerations sustained during childbirth, they account for significant morbidity among sexually active women. Consensual sexual intercourse should ordinarily not cause pain as opposed to rape. It commonly results from inadequate foreplay prior to penetration leading to non-lubrication of the vagina. Severe coital laceration may lead to life threatening blood loss. The authors report their experience with treating patients with coital laceration. The mechanism of injury and treatment modality were also highlighted. Three cases are presented. The first patient bled profusely from the laceration and went into shock due to severity of bleeding. The second case presentation was similar to the first only that she was haemodynamically stable at presentation without any sign of shock. The last case was a newlywed who was having sexual intercourse for the very first time. All three patients were not adequately lubricated prior to penetration due to inadequate foreplay. All three cases were consensual and were either with the lover as in the first two cases or the spouse as in the third case. None of them was circumcised or had had any form of genital mutilation. The case series bring to fore the common mechanism of consensual coital laceration, the need for clinicians to have high index of suspicion when reviewing susceptible patients as well as proper and prompt management of the condition which may require surgical repair as was in all the cases highlighted.

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Section: Discussionmentioning

confidence: 99%

Consensual Coital Lacerations: A Case Series

Tia¹,

Nf²,

Pe³

2017

Gynecol Obstet Case Rep

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“…Emergency exploratory laparotomy for ruptured ectopic pregnancy is arguably considered one of the most common gynecological emergency surgeries performed in contemporary gynecological practice 1,2. It was, therefore, not surprising that it constituted 59% of the total gynecological surgical emergencies managed during the study period.…”

Section: Discussionmentioning

confidence: 99%

Determinants of decision-to-intervention time in the management and therapeutic outcome of emergency gynecological surgeries in south east Nigeria

Onyebuchi

Lawani

Nkwo

et al. 2014

TCRM

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BackgroundPrompt and timely response in the management of gynecological surgical cases can significantly affect the therapeutic surgical outcome of patients in emergency situations. The aim of this study was to evaluate the decision-to-intervention time (DIT), its determinants, and the significance in the therapeutic outcome of emergency gynecological surgeries managed at a federal teaching hospital in south east Nigeria over an 18-month period.MethodsThis was a prospective descriptive study of 105 emergency gynecological cases managed at a federal teaching hospital over an 18-month period. Patients were recruited at the point of admission and followed up until discharge for outcome. Data were abstracted with a data entry pro forma and then analyzed with the Epi Info™ statistical software version 7.0.ResultsThe incidence of gynecological surgical emergencies was 5.1% of the total gynecological cases managed during the study period. The mean DIT was 4.25 (range 1.45–5.50) hours with delay in intervention, mainly due to delays in securing blood/blood products and other materials for resuscitation (46.7%) and a lack of finance (15.2%). Six maternal deaths were recorded, giving a case fatality ratio of 5.7%, while the commonest maternal complications associated with the delays were hemorrhage (61.9%) and the need for blood transfusion (57.1%), respectively. The risk ratio of losing ≥1,000 mL of blood, anemia, hemorrhagic shock, and wound infection in those with DIT ≥120 minutes was statistically greater and significant at 95% confidence interval.ConclusionInadequacies in health care services and policies due to poor infrastructure, organizational framework, and financing were the major determinants of the prolonged DIT and therapeutic outcomes.

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“…[24] However its cost, requirement of general anesthesia, need for trained medical personnel, and nonvisualization of some areas of the uterus had impaired its utilization; especially in developing countries where diagnosis is still largely based on unspecific clinical features. [27,28] Laparoscopic criteria for visual diagnosis of acute pelvic inflammatory disease include marked hyperemia of the tubal surface, edema of the tubal wall, and sticky exudate on the surface of the tube and fimbriae ends when open. [24] These criteria are helpful in identifying sequelae of chronic pelvic inflammatory disease such as pyosalpinx which is diagnosed when tubes are enlarged, edematous with partial or total destruction of the fimbriated end.…”

Section: Diagnosis Of Pelvic Inflammatory Disease --Clinical Featuresmentioning

confidence: 99%

Pelvic inflammatory disease, correlation between clinical and laparoscopic diagnosis – A review.

Tamunomie¹

2013

IOSR-JDMS

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Gynaecological Emergencies in the Tropics: Recent Advances in Management

Cited by 16 publications

References 33 publications

Consensual Coital Lacerations: A Case Series

Consensual Coital Lacerations: A Case Series

Determinants of decision-to-intervention time in the management and therapeutic outcome of emergency gynecological surgeries in south east Nigeria

Pelvic inflammatory disease, correlation between clinical and laparoscopic diagnosis – A review.

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