Analysis of obstetric and gynecological surgeries among adolescent girls: lessons for prevention

Ruchi Kalra, Jyoti Nath Modi

Abstract


Background: Health of adolescent girls is a priority. Any operative surgery affects her physical & psychological health adversely. Aim: The study was done to analyze the operative burden on adolescent girls and identify the health needs of adolescent girls at our institute.

Methods: A cross sectional study was done from May 2010 till Aug 2013. All adolescent girls (19 years age and below) operated during this period at department of obstetrics & gynaecology, People’s college of medical science & RC, Bhopal were included.  

Results: The operations were done on 54 adolescent girls during this period which was 1.37% of the total surgeries. Age wise distribution was as 50% were of 19 years age, 37% were 18 years, 7.4% were of 17 years and 5.5% were 16 years and below. 41% of them were admitted with labour complaints, 26% cases as abortions, 13% cases with pain in abdomen. 11% of cases had cyclical pain with primary amenorrhoea 5% were admitted with Primary amenorrhoea, 4% had complaints of perineum pain. Maximum  surgeries for obstetrical indications were  caesarean sections (41% cases) followed by suction evacuation for abortion(26%). Among gynecological surgeries, maximum were done for imperforate hymen & partial vaginal septum (11% casesexploratory laparotomy for benign ovarian masses (9.25% cases). Diagnostic laparoscopy for primary amenorrhea was done (5.5% cases) and operative laparoscopy (3.7% cases). 1.85% cases each were of pelvic abscess and bartholin cyst where I&D and marsupialization were done respectively.

Conclusions: Obstetric operative burden on adolescent girls was very high. 67% of obstetric related surgeries can be prevented by educating and encouraging them to delay the onset of sexual activity and also by providing health related and contraceptive advices in schools and community settings.

Keywords


Adolescent girls, Gynaecological operations, Adolescent friendly services

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References


UNICEF. National family health survey, 2005-06. In: IIPS, eds. IIPS Survey. Mumbai, India: IIPS; 2007.

NRHM. Adolescent reproductive sexual health (ARSH) RCH II, 2014. Available at: www.nrhm.gov.in/arsh

World Health Organization. Facts sheet: Adolescent pregnancy, 2014. Available at: http://www.who.int/mediacentre/factsheets/fs364/en/. Accessed September 2014.

Mahavarkar SH, Madhu CK, Mule VD. A comparative study of teenage pregnancy. J Obstet Gynaecol. 2008;28(6):604-7.

The Girl Effect. The girl declaration, 2014. Available at: www.girleffect.org/the-girl-effect-in-action/girl-declaration.

Government of India. Implementation guide on RCH II adolescent reproductive sexual health strategy. In: GOI, eds. GOI Guide. India: Ministry of Health and Family Welfare; May 2006.

Karine Morcel, Laure Camborieux, Daniel Guerrier. Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Orphanet J Rare Dis. 2007;2:13.

Alfonsa Pizzo, Antonio Simone Laganà, Domenico Puzzolo. Mayer-Rokitansky-Kuster-Hauser syndrome: embryology, genetics and clinical and surgical treatment. ISRN Obstet Gynecol. 2013;2013:628717.

Chelli D, Kehila M, Sfar E, Zouaoui B, Chelli H, Chanoufi B. Imperforate hymen: can it be treated without damaging the hymenal structure? Sante. 2008 Apr-Jun;18(2):83-7.

Pandis GK, Michala L, Creighton SM, Cutner AS. Minimal access surgery in adolescent gynaecology. BJOG. 2009;116:214-9.

Claire Templeman, Mary E. Fallat, Alexandra Blinchevsky, S. Paige Hertweck. Non-inflammatory ovarian masses in girls and young women. Am Coll Obstet Gynecol. 2000 Aug;96(2):229-33.

Nirmal Kumar Bhattacharyya, Anuradha De, Rajat Bandopadhyay. Ovarian tumors in pediatric age group - a clinicopathologic study of 10 years’ cases in West Bengal. Indian J Med Paediatr Oncol. 2010 Apr-June;31(2):54-7.