Tropical doctor
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Acute bleeding after delivery can be a life-threatening complication. Emergency hysterectomy is usually undertaken as a last resort. This study was conducted in order to estimate the incidence, indications, risk factors and complications associated with peripartum hysterectomy performed at a tertiary care hospital. ⋯ The duration of surgery was shorter (P = 0.045) but the complications were higher (P = 0.029) in total compared with subtotal hysterectomies. Our results suggest that caesarean deliveries are associated with an increased risk for peripartum hysterectomy, which is of concern given the increasing rate of caesarean deliveries. Subtotal hysterectomy is a reasonable alternative in emergency obstetric hysterectomy.
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Severe meconium aspiration syndrome is difficult to manage and has a high mortality in developing countries. Guidelines are available for the initial management. If the infant has been born through particulate meconium and is not vigorous, an inspection of the vocal cords by laryngoscopy is recommended. ⋯ However, as this needs a way of applying suction directly to the endotracheal tube it can be problematic. Commercially available equipment does exist, but in a resource-scarce setting, its cost could be prohibitive. We have adapted cheap suction connectors which can be adapted for this purpose.