Hysterectomy is indicated in postpaum period for: March 2007
Ans. D: PPH not controlled by ligation of internal iliac Hysterectomy is normally recommended for: Reproductive system cancers (uterine, cervical, ovarian). As a prophylactic treatment for those with either a strong family history of reproductive system cancers. Severe and intractable endometriosis (overgrowth of the uterine lining) and/or adenomyosis (a more severe form of endometriosis, where the uterine lining has grown into and sometimes through the uterine wall). Postpaum to remove either a severe case of placenta prae (a placenta that has either formed over or inside the bih canal) or placenta accreta (a placenta that has grown into and through the wall of the uterus to attach itself to other organs), as well as a last reso in case of excessive postpaum bleeding. Several forms of vaginal prolapse. Heavy or abnormal menstrual bleeding. Hysterectomy is occasionally performed for fibroid (benign tumor-like growths inside the uterus itself made up of muscle and connective tissue). Most hysterectomies are done laparotomy/ open technique/ open hysterectomy. The open technique carries increased risk of hemorrhage due to the large blood supply in the pelvic region, as well as an increased risk of infection. However, an open hysterectomy provides the most effective way to ensure complete removal of the reproductive system as well as providing a wide opening for visual inspection of the abdominal cavity. Complications: Hemorrhage Infection Constipation Urinary retention Blood clots -- Pelvic surgery increases the risk of developing blood clots in the large veins of the leg or lung. Damage to adjacent organs-The urinary bladder, ureters and large and small intestines are located in the lower abdomen and pelvis and can be injured during hysterectomy. Early menopause
Twin pregnancy
Endometriosis
Fibroid uterus
PPH not controlled by ligation of internal iliac aery