PATTERN AND DETERMINANTS OF PERIOPERATIVE COMPLICATIONS AMONG WOMEN UNDERGOING OBSTETRIC AND GYNAECOLOGICAL SURGERIES IN A TERTIARY CARE SETTING
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Keywords
Perioperative complications; Obstetric surgery; Gynaecological surgery; Anaesthesia; Maternal morbidity; Hospital-based study.
Abstract
Obstetric and gynaecological surgeries constitute a major proportion of surgical workload in tertiary care hospitals and are associated with unique perioperative risks arising from physiological changes of pregnancy, high prevalence of anaemia, emergency surgical indications, and diverse anaesthetic techniques. Anaesthesia-related factors such as choice of anaesthetic technique, airway management, and intraoperative haemodynamic stability play a crucial role in perioperative outcomes. However, hospital-based data from India evaluating the burden and pattern of perioperative complications with reference to anaesthetic variables remain limited. Aims and Objectives: To assess the burden and spectrum of perioperative complications among women undergoing obstetric and gynaecological surgeries at a tertiary care hospital and to evaluate the association of selected perioperative and anaesthetic variables with these complications. Methods: A hospital-based observational study was conducted among 52 women undergoing obstetric and gynaecological surgeries at a tertiary care teaching hospital over a defined period. Data were collected using a structured proforma and included socio-demographic characteristics, type and indication of surgery, anaesthetic technique (general or regional anaesthesia), ASA physical status, airway assessment and management, intraoperative haemodynamic events, and estimated blood loss with transfusion requirement, along with preoperative clinical parameters, intraoperative events, and postoperative outcomes. Perioperative complications were classified as intraoperative and postoperative. Data were analysed using descriptive statistics, and associations between selected perioperative and anaesthetic variables and the occurrence of complications were assessed using appropriate statistical tests. A p-value of <0.05 was considered statistically significant. Results: Perioperative complications were observed in 40.4% of the study participants. Common intraoperative complications included hypotension, excessive blood loss, and airway-related events, while postoperative complications comprised pain requiring additional analgesia, postoperative nausea and vomiting, wound-related complications, and prolonged hospital stay. A higher incidence of complications was noted among women undergoing emergency procedures, those with higher ASA physical status, preoperative anaemia, longer duration of surgery, intraoperative haemodynamic instability, and increased blood loss requiring transfusion. Several anaesthetic and perioperative variables showed a statistically significant association with the occurrence of complications.
Conclusion: The study highlights a considerable burden of perioperative complications in obstetric and gynaecological surgeries in a tertiary care hospital setting, with anaesthetic factors playing a significant contributory role. Careful preoperative risk stratification, optimisation of anaemia, appropriate choice of anaesthetic technique, vigilant airway management, and strict intraoperative haemodynamic monitoring may help reduce perioperative morbidity. Strengthening adherence to standard anaesthetic and perioperative protocols can improve maternal surgical outcomes.
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Dr Varsha M
Associate Professor of OBG, Department of OBG, Viswabharathi Medical College and General Hospital, Penchikalapadu, Kurnool, A.P.
Dr Kranti Kumar GTS
Associate Professor of Anaesthesiology, Department of Anaesthesiology, Fathima Institute of Medical Sciences, Kadapa- 516003, Andhra Pradesh.
Dr. Nivedita Reshme
Assistant Professor of OBG, Department of OBG, Ramaiah Medical College, Bengaluru, Karnataka.
