An audit of gynaecological procedures performed at Aminu Kano Teaching Hospital, Kano

Abstract

Background: Audit of all gynecological procedures as one of the commonest operations performed in medical practice is not routinely done in developing countries, including Nigeria. Aim: The study was aimed at determining the rate of all gynecological procedures performed; the common gynecological procedures and their indications, and the cadre of surgeons that performed different gynecological procedures within the period under review. Materials and Methods: A 1-year retrospective chart analysis of all gynecological procedures performed at Aminu Kano Teaching Hospital (AKTH) between 01/10/2012 and 30/09/2013 was conducted. Patients with complete relevant information in the registers were included in the audit and those with incomplete data were excluded. Data was further cleaned and analyzed using Microsoft Excel for Mac 2011, for frequencies and percentages. Results were presented by simple statistical tables. Results: A total of 6,604 patients were gynecological attendees, out of which 646 patients had gynecological procedures performed, giving an institutional gynecological procedure rate of 9.8% (646/6,604), within the period under review. Emergency gynecological procedures accounted for 5.9% (38/646), while the elective cases accounted 4.0% (26/646). Majority of the gynecological procedures was among the 20-40 years age group. About 20 different types of gynecological procedures were done and manual vacuum aspiration (MVA), for incomplete miscarriage accounted for 58.8% (380/646), while excision of transverse vaginal septum was the least at 0.3% (2/646) of all the gynecological procedures. Interns, registrars, senior registrars, and consultants were involved in performing the different gynecological procedures. Between 69 and 100% (446/646-646/646) of some of the major gynecological procedures were carried out by consultants, 14-27% (90/646-174/646) by senior residents (SRs), while the junior residents and interns performed only MVAs among the gynecological procedures at 53.1% (343/646) and 7.3% (47/646), respectively. Conclusion: The common gynecological procedure performed in AKTH is MVA by all cadres of surgeons, and consultants performed the highest number of all the gynecological procedures except MVA. A more regular audit of services rendered by the department is advocated. This may help to identify the gaps in training and services.