Counselling about risk in Gyanecology

Presenting information on risk :

 

Term	Numerical ratio	Colloquial description
Very common	1/1 to 1/10	A person in family
Common	1/10 to 1/100	A person in street
Uncommon	1/100 to 1/1000	A person in village
Rare	1/1000 to 1/10 000	A person in small town
Very rare	Less than 1/10 000	A person in large town

 

 

 

 

RCOG Consent Advice 9 - Perineal Tears Following Childbirth :

 

Serious risks -

1. Incontinence of stools and/or flatus - 
 Common

1/10 to 1/100

A person in street

 
2. Delivery by caesarean section in future pregnancies may be recommended if symptoms of incontinence persist or investigations suggest abnormal anal sphincter structure or function.

Uncommon:

1/100 to 1/1000

A person in village

  
 3. Haematoma. 
 4. Consequences of failure of the repair requiring the need for further interventions in the future such as secondary repair or sacral nerve stimulation.

Rare:

1/1000 to 1/10 000

A person in small town

5.  Rectovaginal fistula.

Very rare:

Less than 1/10 000

A person in large town

 

 

RCOG Consent Advice 10 - Surgical evacuation of the uterus :

 

Serious risks include:

• Uterine perforation, up to five in 1000 women (uncommon-A person in village)
• Significant trauma to the cervix (rare-A person in small town)

Frequent risks include:

• Bleeding that lasts for up to 2 weeks is very common but blood transfusion is uncommon (1–2 in 1000 women)
• Need for repeat surgical evacuation, up to five in 100 women (common)
• Localised pelvic infection, three in 100 women (common).

RCOG Consent Advice 12 - CS for placenta previa :

 

In all women with placenta praevia:

• Emergency hysterectomy, up to 11 in 100 women (very common)
• Massive obstetric haemorrhage, 21 in 100 women (very common).
• Need for further laparotomy during recovery from the caesarean, 75 in 1000 women (common)
• Thromboembolic disease, up to three in 100 women (common)
• Bladder or ureteric injury, up to six in 100 women (common)
• Future placenta praevia, 23 in 1000 women (common)