consent Flashcards
Risk of uterine perforation: ERPC for PPH
5.1-5.7%
Risk of uterine perforation: Curretage intrauterine adhesions
0.07-1.8%
risk of uterine perforation: TOP
0.4-0.6%
risk of uterine perforation: hysteroscopy
0.2-2%
overall risk complications hysterectomy
4/100
risk blood transfusion hysterectomy
23/1000
risk damage to bladder or ureter in hysterectomy
7/1000
risk return to theatre for hysterectomy
7/1000
hysterectomy: risk pelvic abscess or infection
2/1000
hysterectomy: risk VTE
4/1000
hysterectomy: risk damage to bowel
4/10 000
hysterectomy: risk death within 6 wks
32/100 000
vag repair: blood tx or RTT
2/100
vag repair: damage to bladder
2/1000
vag repair: damage to bowel
5/1000
vag repair: pelvic abscess
3/1000
% bowel injuries that may be missed during laparoscopy
15%
SMM: heavy bleeding requiring transfusion
0-3/1000
SMM: infection
40/1000
SMM: RPOC
40/1000
SMM: repeat surgery (for RPOC)
3-18/1000
SMM: intrauterine adhesions
16-18%
SMM: cervical trauma
<1/1000
SMM: uterine perf
1/1000
(up to 15/1000)
anterior wall most common (40%)
SMM: overall complication rate
6%
laparoscopy: ureteric injury
1-2%
up to 20% in deep infiltrating endometriosis
complete transection most common
laparoscopy: ureteric injury diagnosed postop
70%
laparoscopy: bladder injury diagnosed postop
50%
amniocentesis: failure to obtain sample
6% after 1 attempt
amniocentesis: miscarriage
1% over norm
amniocentesis: blood stained sample
0.8%
amniocentesis: rare
fetal injury
maternal bowel injury
amniocentesis: severe sepsis
<1/1000
diagnostic hysteroscopy: overall risk of serious complications
2/1000
diagnostic hysteroscopy: frequent risks
infection
bleeding
diagnostic hysteroscopy: serious risks - uncommon
damage to uterus
failure to gain entry/complete procedure
diagnostic hysteroscopy: serious risks - rare
damage to bowel, bladder or vessel
infertility
diagnostic hysteroscopy: serious risks - very rare
death 3-8/100 000
c/s: readmission to hospital
5/100
c/s: hemorrhage
5/1000
c/s: infection
6/100
c/s: persistent wound and abdominal discomfort
9/100
c/s: emergency hysterectomy
7-8/1000
c/s: later surgery
5/1000
c/s: admission to ITU
9/1000
c/s: bladder injury
1/1000
c/s: ureter injury
3/10 000
c/s: VTE
4-16/10 000
c/s: death
1/12 000
8.3/100 000
c/s: future risk of antepartum SB
1-4/1000
c/s: future risk of placental abnormalities
4-8/1000
c/s: complication rate for intrapartum vs planned
emergency 24/100
planned 16/100
c/s: complication rate for first vs second stage
first 17/100
second 33/100
vag repair: death within 6 weeks
37/100 000
vag repair: frequent risks
UTI, retention, frequency Vaginal bleeding post-op pain dyspareunia wound infection
oasis: very rare risks
rectovaginal fistula
oasis: rare risks
hematoma
failure of repair requiring further interventions
oasis: uncommon
delivery by c/s in future depending on symptoms and investigations
oasis: common
incontinence of stools/flatus
wound infection 8/100
perineal pain and dyspareunia 9/100
oasis: fecal urgency
26/100 very common
oasis: frequent risks
fear, difficulty, discomfort passing stools
migration of suture material requiring removal
granulation tissue formation
UTI
wound infection
pain
fecal urgency
oasis: wound infection
8/100
oasis: pain and dyspareunia
9/100
diagnostic laparoscopy or laparoscopy for tubal ectopic: overall risk of serious complications
2/1000 (uncommon)
laparoscopy for tubal ectopic: persistent trophoblastic tissue when salpingostomy performed
4-8%
diagnostic laparoscopy or laparoscopy for tubal ectopic: risk of death
3-8/100 000
laparoscopy for tubal ectopic: frequent risks
inability to identify cause bruising shoulder tip pain wound gaping or infection persistent trophoblastic tissue
laparoscopy for tubal ectopic: serious risks
damage to bowel, bladder, uterus, vessels
failure to gain entry requiring laparotomy
hernia at site of entry
death
OVB: PPH
1-4/10 (very common)
OVB: retinal hemorrhage
17-38/100 (very common)
OVB: cephalhematoma
1-12/100 (common)
OVB: facial or scalp laceration
1/10
OVB: neonatal jaundice
5-15/100
OVB - vacuum - risk of OASIS
1-4/100 (common)
OVB - forceps - risk of OASIS
8-12/100 (very common)
OVB - vacuum - extensive tears
1/10
episiotomy + repair 5-6/10
OVB - forceps - extensive tears
1/5 (20%)
episiotomy + repair 9/10
OVB - subgleal hematoma
3-6/1000 (uncommon)
OVB - intracranial hemorrhage
5-15/10 000 (uncommon)
c/s previa: risk of MOH
21/100
c/s previa: risk of hysterectomy
11/100 (27/100 if previous c/s)
c/s previa: risk of further laparotomy
75/1000
c/s previa: risk of VTE
3/100
c/s previa: risk of bladder or ureter injury
6/100 (common)
c/s previa: risk of future previa
23/1000
2%
c/s previa: frequent risks
admission to ITU
infection
blood transfusion
admission to NICU
sterilisation: failure resulting in unplanned pregnancy at 10y
2-5/1000
1/500 up to 1/200
sterilisation: visceral or blood vessel injury
2/1000
sterilisation: death
1/12 000 (very rare)
8/100 000
sterilisation: risk of laparotomy
3/1000
vasectomy failure rate
1/2000
morcellation: risk of disseminated fibroids
1/120-1200
very common risk: 1 in ____
1 to 10 (person in family)
common risk: 1 in ___
10 to 100 (person on street)
uncommon risk : 1 in ____
100 to 1000 (person in village)
rare risk: 1 in ____
1000 to 10 000 (person in small town)
very rare risk: 1 in ____
<10 000
risk of bowel injury in laparoscopy
0.4/1000
risk of vascular injury in laparoscopy
0.2/1000
