caa a22 4500 445308214 CHVBK 20180317142620.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1007/s00404-010-1820-7 doi (NATIONALLICENCE)springer-10.1007/s00404-010-1820-7 Destructive operations—a vanishing art in modern obstetrics: 25year experience at a tertiary care center in India [Elektronische Daten] [Pooja Sikka, Seema Chopra, Arun Kalpdev, Vanita Jain, Lakhbir Dhaliwal] 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 25years, between 1983 and 2007, was carried out. Results: Of a total of 85,952 deliveries in PGIMER in these 25years, 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. Springer-Verlag, 2010 Destructive operations nationallicence Craniotomy nationallicence Obstructed labor nationallicence Sikka Pooja Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut Chopra Seema Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut Kalpdev Arun Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut Jain Vanita Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut Dhaliwal Lakhbir Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 929-933 0932-0067 283:5<929 2011 283 404 https://doi.org/10.1007/s00404-010-1820-7 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00404-010-1820-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sikka Pooja Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Chopra Seema Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Kalpdev Arun Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Jain Vanita Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Dhaliwal Lakhbir Department of Gynaecology and Obstetrics, PGIMER, 160012, Chandigarh, India aut NATIONALLICENCE 773 0- Archives of Gynecology and Obstetrics Springer-Verlag 283/5(2011-05-01), 929-933 0932-0067 283:5<929 2011 283 404 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer