About the Health Information

• To handle any obstetric and gynaecological emergencies, a well-equipped hospital should have four elements — a good Emergency department to stabilise the patient and effectively identify the cause of the emergency, ultrasound facilities for faster diagnosis, an onsite blood bank for situations requiring immediate transfusion and a fully-prepped operation theatre for unexpected surgeries. At MGM Healthcare, we have all of these facilities along with experienced obstetricians and gynaecologists to treat any emergency.

• In an emergency, all you need to do is call 044-45242444 for an ambulance or come directly to our 24×7 Emergency Centre.

Types of emergencies

• Patients may either be referred to emergency from another hospital or may walk in by themselves without referral. When they are referred, often, the cause of the emergency is known and the doctors can prep to treat the patient accordingly. But many cases are walk-ins and it is the Emergency Physicians who provide efficient first-line management like stabilising the patient and ordering blood tests and scans. Prompt action by this team results in faster diagnosis and the respective department is called in.

Gynaecological emergencies include:

• Ruptured tubal pregnancy

• Miscarriage

• Ovarian torsion (adnexal torsion)

• Ruptured ovarian cyst

• Haemorrhagic ovarian cyst

Obstetric emergencies include:

• Placental abruption

• Placenta previa

• Eclampsia

• Obstructed labour

• Cord prolapse

• Postpartum haemorrhage

Gynaecological emergencies: How they are handled

• In cases like a ruptured tubal (ectopic) pregnancy, which poses as a high-priority gynaecological emergency, the patient may not be responsive when brought in due to shock from immense blood loss. The first step when a patient is brought in to the ER unresponsive is to resuscitate them. Upon resuscitation, an immediate blood transfusion might be required if the blood loss is significant. Once the patient is stabilised, an ultrasound scan of the pelvis is performed using the portable ultrasound scanner to make a faster diagnosis. If the patient requires surgery to stop the bleeding, then they are taken to the operation theatre.

• Other gynaecology-related emergencies, like ovarian torsion, ruptured ovarian cyst and haemorrhagic ovarian cyst, may only present with non-life-threatening symptoms like severe pain, abdominal swelling or bloating, fever and nausea/vomiting. This gives the doctors more time to assess the situation, take the patient’s vitals and a detailed history and then begin the appropriate treatment.

Obstetric emergencies: How they are handled

• On the other hand, obstetric emergencies are considered more serious as these conditions can pose a risk to both the mother and her unborn child. An emergency delivery of the baby that might be premature (26-37 weeks) might be required to save both mother and child in many cases. With a level-III Neonatal ICU in the hospital, the decision can be taken with more surety. It is crucial to examine the mother and perform an immediate scan so as to decide if she should be taken to the labour ward or the operation theatre for an emergency C-section.

• Conditions involving the placenta may require immediate delivery by C-section and possible blood transfusion due to heavy blood loss. Placental abruption is a condition where there is profuse bleeding behind the placenta leading to the formation of big clots. Placenta previa is a condition where the placenta is low-lying and it starts bleeding. Both these conditions cause torrential bleeding that can threaten the life of the mother and may also threaten the life of the baby. Some women, who have been diagnosed with sudden high blood pressure during pregnancy, present in the hospital with eclampsia. It results in seizures before, during or after delivery and such cases require immediate intensive care.

• At MGM Healthcare, patients are at the core of everything we do. We have the necessary facilities (24×7 ER, onsite blood bank, emergency OT, ICU, NICU), technology and expertise to handle any level of emergency.