title: Surgical emergencies in obstetrics and gynaecology in a tertiary care hospital.
abstract: BACKGROUND
  The management of Obstetrics and Gynaecological Emergency is directed at the preservation of life, health, sexual function and the perpetuation of fertility. Main aim of the study was to access the burden of Surgical Emergency in Obstetrics and Gynaecology and their course of management at BPKIHS.
  
  
  METHODS
  A total of 314 women presenting at the emergency admission room of Obstetrics and Gynaecology Department of BPKIHS over two years, who required surgical intervention were included in this hospital based descriptive study. Clinical assessment and routine laboratory investigations were performed in all cases. All patients who presented with shock were resuscitated and surgery was done at earliest possible time.
  
  
  RESULTS
  The age of patients ranged from 15- 55 years with approximately 43% in the 25-34 years category. Ninety two percent of them were married. Among the unmarried, 64% came with problems related to unsafe abortion. About 61% of females presenting as acute surgical abdomen had ruptured ectopic pregnancy, 7.64% had twisted ovarian cyst, and 6.26% had haemoperitoneum and pyoperitoneum following vaginal hysterectomies, total abdominal hysterectomies and caesarean section. Almost half (47.8%) of the cases underwent salphingectomy.
  
  
  CONCLUSIONS
  Women present with wide range of complaints and conditions in the admission room of Obstetrics and Gynecology department of BPKIHS. Skilled clinicians, immediate investigation facilities and experienced specialty Obstetrical and Gynaecological surgeons are the main backbone of the emergency case management and saving lives. Study indicates there is need of some prospective study to establish the causes of rising trend in Ectopic Pregnancies.
authors.affiliation: Department of Obstetrics and Gynaecology, BP Koirala Institute of Health Sciences.
authors.forename: Hanoon P
authors.initials: HP
authors.lastname: Pokharel
authors.forename: Prerana
authors.initials: P
authors.lastname: Dahal
authors.forename: Rubina
authors.initials: R
authors.lastname: Rai
authors.forename: ShyamSundar
authors.initials: S
authors.lastname: Budhathoki
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008875:Middle Aged; D009390:Nepal; D013513:Obstetric Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D012959:Socioeconomic Factors; D063128:Tertiary Health Care; D055815:Young Adult
keywords: ectopic pregnancy, emergency, gynaecological, obstetrics