Obstetricians' statement on symphysiotomies

[Posted: Fri 19/02/2010 www.irishhealth.com]

The Institute of Obstetricians and Gynaecologists has said the historic use of symphysiotomy should be assessed in the context of what was considered valid practice at the time.

The Institute issued a statement this week as last night's RTE Prime Time programme revealed that symphysiotomies, which caused severe side-effects in many women, were commonly practised here between the 1940s and the 1980s, when the practice was no longer in regular use in other developed countries.

The Survivors of Symphysiotomy (SOS) group has been highly critical of previous advice from the Institute to the Department of Health on symphysiotomy.

It claims the Institute's advice to the Department on which its decisions to date not to hold an inquiry into the practice were made have been shown to be discredited.

It claims inaccurate assertions were made by the Institute in terms of the safety and efficacy of and the need for symphysiotomy practice in Ireland, at a time when it was not common practice in other developed countries.

The Institute, in its statement, said its members offer their unreserved sympathy and support to any mother who may have experienced complications following symphysiotomy

It said it had previously written in support of mothers who suffered adverse outcomes following the procedure.

"In these letters, the Institute has recommended that mothers should be given a full explanation, to which they were untitled, and that their grievances should be considered sympathetically."

The Institute said that data on symphysiotomy should be recorded into a national clinical audit on obstetric practice.

It said the benefits of the procedure include that the increase in pelvic size allows vaginal birth in selected cases of obstructed labour.

This in turn reduces maternal and infant death and morbidity rates and complications such as incontinence that can result from prolonged obstructed labour.

It says immediate complications may include pelvic joint pain and difficulty walking, and bladder infection and incontinence may occur.

The Institute said that symphysiotomy is no longer used in Ireland as an alternative to caesarean sections for obstructed labour, but may be used in extremely rare emergency cases. It said in some countries it may be used  s a life-saving procedure for mother and infant where caesareans are not an option.

It said symphysiotomies had been used since the 18th century and it had previously been a simpler and safer practice than caesarean section, which gradually replaced it. Caesarean section, it said, until the operation was refined, was itself a cause of maternal death, mainly due to blood loss and infection.

The Institute said because symphysiotomy permanently enlarged the pelvis, it also offered the prospect of safer vaginal delivery in future pregnancies at a time when large families were the norm.

Read the Institute's full statement here

anony  Posted: 19/02/2010 22:37

I was sickened by that report on TV and the reaction of the former chairman added to my sickness. Some consultants really worry me as I ask myself - what other things are being done that people will be reading about in 25 years time and that patients will still suffer the consequences.

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