Epidemiology, Risk Factors and Outcome of Complications in Obstetric and Gynecological Surgeries—A Tertiary Center Experience from Western India

Abstract

AIM: The aim of the study is to find out the risk factors for complications in major obstetrics and gynecological surgeries and to study their outcome. METHODS: This is a single center prospective study carried out at a tertiary care center between July 2010 and June 2013. All patients undergoing major obstetric and gynecological surgeries during this period were included. All patients were evaluated by history, detailed clinical examination, complete blood count and liver function tests. All patients were monitored intraoperatively and details regarding type of anesthesia, duration of surgery, type of surgery and intra operative vital parameters were noted. Complications either intraoperative or postoperative were studied. RESULTS: A total 1526 patients were studies. Out of these, 818 surgeries were obstetric surgeries while rests were gynecological surgeries. There were 88 (5.7%) complications among them. Age and socioeconomic status did not affect the complications, while BMI (Body Mass Index) and anemia were strong predictors for complications. Intra operative complications were more common in obstetric surgery owing to emergency status. 16.6% mortality was seen among obstetric complications mostly in cesarean section group though complications were more common after non cesarean laparotomy. Abdominal hysterectomy with oopherectomy, laparoscopic assisted vaginal hysterectomy and mymectomy were most common gynecological procedures with complications. Surgical reintervention was more common after gynecological surgery complication. Type of anesthesia did not affect the outcome. Overall, the complications doubled the duration of stay and increased the cost of surgery by 8 times. CONCLUSION: Gynecological and obstetric surgery are equally associated with complications. Age, socioeconomic factors and type of anesthesia did not increase the rate of complications while pre operative obesity, anemia and emergency indications increase the rate of complications.