Pattern of gynecological admissions and outcomes of patients who are admitted to gynecological ward and ICU of SPHMMC
Abstract
Background
Gynecologic disorders might be grossly classified as emergency and elective. Emergency gynecologic admissions are usually due to abortion, ectopic pregnancy, molar pregnancy, medical complications of pregnancy, ovarian cyst torsion, abnormal uterine bleeding, and pelvic pain and infection, etc. Elective gynecologic admissions might be classified as malignant and benign. Non-malignant gynecologic disorders are uterine myoma, pelvic organ prolapse, infertility, preinvasive leisions of the genital tract, anemia, and so on (1). Gynecologic malignancies are primary cancers of the reproductive system i.e. the ovary, fallopian tubes, uterus (and cervix), vagina and vulva. They are usually epithelial in origin which might result from environmental agents such as infectious agents, chemicals, ionizing radiation and some of them are familial and usually occur at postmenopausal age group. Gynecological cancers continue to be important health problems worldwide. The proportion of cancers in the female which are of genital tract origin range from 31.6% to 35.0% in sub-Saharan Africa, 12.7% to 13.4% in North America, 13.9% to 16.8% in France and the Scandinavian countries, 15.5% to 43.1% in South America and 22.4% to 55.8% in India (2).
Gynecologic disorders, although, they have differences between the various types as regards the age and parity incidence, a changing pattern in the clinical presentation and distribution has been reported in various communities over the years (3). Of all cancers occurring in sub-Saharan Africa, gynecologic malignancies have emerged as a major cause of morbidity and mortality. Of cancers occurring in Africa, 36% result from (4).
Patients with primary gynecologic disorders present with symptoms like non-specific symptoms (such as fatigue, abdominal distention, bloating, pelvic pressure sensation, fevers, weight loss),urinary urgency, frequency and dysuria, abnormal vaginal discharge, abnormal uterine bleeding and symptoms related to anemia (e.g. reduced exercise capacity, recent onset of breathlessness, headache, tinnitus, presence of ankle oedema), failure to conceive, amenorrhea, pregnancy and related complications (such as nausea and vomiting, vaginal bleeding, abdominal pain),symptoms relating to cancer and metastasis (such as abdominal mass, cough, shortness of breath, back pain, ascites, headache), evidence of compromised immunity (recurrent oropharyngealor vaginal infection) and symptoms related to potential haemostatic problems (easy bruising, bleeding episodes, rashes).