Emergency Obstetric Hysterectomy, Risk Factors, Indications and Outcome: A Retrospective Two Year Study

Abstract

Background: Obstetric emergency hysterectomy means that emergency hysterectomy which is taken after drug therapy and conservative surgery fails to control blood loss from gravid uterus. It is the last resort to save mother’s life, and beside, the mother’s reproductive capability is sacrificed. Objectives: To study the cases of peripartum hysterectomy over a period of 2 years from Jan 2015 – Dec 2016 in tertiary centre of Geetanjali Medical College and Hospital, Udaipur, to assess incidence, indication, risk factor and maternal outcome. Methods: 18 cases of emergency hysterectomies which were performed during the study period data were taken and were assessed. Results: During the study period, incidence of obstetric hysterectomy is 0.52%. Most common indication for obstetric emergency hysterectomy is atonic PPH (27.77%). Hemorrhagic shock(61.11%) is most common complication followed by bladder injury(27.11%). Conclusion: Elderly gravida with IVF pregnancy, history of previous cesarean (with adherent placenta) and history of myomectomy are risk factors for peripartum hysterectomy. These cases should be dealt cautiouly and should be handled at tertiary centres.