Evaluation of series of 177 cases of acute gynaecological emergencies in tertiary care hospital

摘要

Background: Gynecologic emergencies are relatively common and acute pain of pelvic origin is a common symptom necessitating emergency medical evaluation, because late diagnosis, potentially leading to progression to severe morbidity or death, is a matter of concern. The objective of present study is to have an overview of emergency gynecological conditions and their management. Methods: In present retrospective observational study total 177 cases were analyzed. They were divided into three groups depending on age, adolescent group patients aged 19 year and below (group A), reproductive group between 20 to 44 year (group B) and perimenopausal/postmenopausal group aged 45year and above (group C). The data collected were expressed as mean±S.D. Results: The distribution of cases was as follows: 29 cases (16.38%) in group A with a mean age of 15.5±2.21 years, 97 cases (54.80 %) in group B with a mean age of 24.20±4.38 years and 51 cases (28.81%) in group C with a mean age of 46.75±9.11 years. Pain was in right lower quadrant (36.70%), in left lower quadrant (27.95%), suprapubic (19.35%) and diffuse (16%). The most common etiology of APP were as follows: simple ovarian cysts in 16.9% patients followed by ectopic pregnancy (15.2%), complication of uterine fibroid (10.7%), rupture ovarian of cysts (9.7%) and haemorragic ovarian cysts (6.8%). Modality of management in all of the groups was as follows: observation in 21.5%, medical in 25.4% and surgical in 53.1%. Conclusions: Accurate clinical and laboratory evaluation are essential in gynecological emergencies. There should be a high index of suspicion for early detection and early intervention to reduce morbidity and mortality.