Archives of Gynecology and Obstetrics

, Volume 283, Issue 5, pp 929–933 | Cite as

Destructive operations—a vanishing art in modern obstetrics: 25 year experience at a tertiary care center in India

  • Pooja Sikka
  • Seema Chopra
  • Arun Kalpdev
  • Vanita Jain
  • Lakhbir Dhaliwal
Materno-fetal Medicine
First Online:
Received:
Accepted:

Abstract

Background

Destructive operations have a limited role in modern day obstetrics. In the developed countries, obstetrics has become so advanced that these instruments have actually been put away. However, in developing countries like India, these procedures have a limited role where obstructed labor still continues to plague thousands of women every year and accounts for 8% of maternal deaths. This study was planned to define the changing role of destructive operations in obstetrics over the years as more number of abdominal deliveries are conducted in modern day obstetrics than these procedures.

Materials and methods

A retrospective analysis of destructive operations performed at the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, over a span of 25 years, between 1983 and 2007, was carried out.

Results

Of a total of 85,952 deliveries in PGIMER in these 25 years, there were 25,474 cesarean deliveries (29.63%), and 8,826 (10.26%) operative vaginal deliveries. The total number of destructive operations performed was 230 (0.26%). There were 202 craniotomies (87.8%), 13 decapitations (5.7%), 8 eviscerations (3.6%) and 7 cleidotomies (2.9%).

Conclusion

There should be an individualized approach to each case of obstructed labor. The health care provider has to decide on the options available to him to deliver the mother by the safest route without causing morbidity and mortality. If the fetus is dead, a destructive procedure can be considered in place of abdominal-route delivery which carries considerable risk to the debilitated mother in neglected labor.

Keywords

Destructive operations Craniotomy Obstructed labor 
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Notes

Conflict of interest

None.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Pooja Sikka
    • 1
  • Seema Chopra
    • 1
  • Arun Kalpdev
    • 1
  • Vanita Jain
    • 1
  • Lakhbir Dhaliwal
    • 1
  1. 1.Department of Gynaecology and ObstetricsPGIMERChandigarhIndia

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