DESTRUCTIVE OPERATIONS STILL HAVE A PLACE IN DEVELOPING-COUNTRIES

OBJECTIVES: To determine the place of destructive operations in develo ping countries in patients arriving late in labor with a dead fetus an d advanced infection, and to compare them with LSCS for patients with similar indications. METHODS: A total of 56 cases of destructive opera tions were carried out on patients with obstructed labor and intrauter ine fetal death (IUFD) from the labor wards of Smt. S.K. Hospital from January 1985 to December 1991. These were compared with 27 cases of L SCS done for similar indications during the years 1989 to 1990. RESULT S: Patients treated with destructive operations had no maternal deaths , had very few complications and required a short hospital stay. Patie nts treated by LSCS, however, had one maternal death and complications such as post-partum hemorrhage, incidence of blood transfusion, post- operative shock, post-operative pyrexia and duration of hospital stay were more frequent. CONCLUSIONS: It is felt that in some properly sele cted cases presenting late with obstructed labor, IUFD and intrauterin e sepsis, destructive operations should be performed as first choice. Thus, destructive operations still have a Iimited place in developing countries and are safer than LSCS for these patients.