Pregnancy-related deaths in four published perioperative mortality review reports were analysed. The aim is to look at the quality of surgical and anaesthetic services along with the perioperative care provided. The audit identified shortfalls in the logistic and support services and recommended remedial strategies. The review was conducted by a committee consisting of practising anaesthetists, surgeons and obstetricians who analysed the questionnaires collectively. A consensus was reached to categorise the death. There were 280 pregnancy-related deaths. Post-partum haemorrhage accounted for 31.8%, followed by hypertensive disorders of pregnancy (20.0% obstetric embolism (16.1%), sepsis (10.7%) and associated medical conditions (21.4%). In brief, there were comings in preoperative, intra-operative and post-operative care in some of the cases. Increased consultant input, clinical audit, improvements in monitoring and expansion of critical care facilities were the integral issues recommended.
Surgery induces a 'stress' state leading to post-operative hyperglycaemia. To investigate this effect on patients with Type 2 Diabetes Mellitus, we reviewed the records of 50 diabetic patients who underwent surgery without intraoperative insulin. Demographic features together with pre-operative and post-operative blood glucose readings were noted. 27.3% of patients with well controlled pre-operative blood glucose levels developed post-operative hyperglycaemia. In contrast, 84.6% of patients with poorly controlled levels developed the same. Poor control of blood glucose and duration of operation were the only significant predictors of post-operative hyperglycaemia.