Emergency Peripartum Hysterectomy: A Retrospective Study at a Tertiary Care Hospital in Karnataka

Abstract

Objectives: The main objectives of this study were to determine the incidence, maternal characteristics, indications, the maternal and perinatal outcomes at J.J.M. Medical College, Teaching Hospital, Davangere, Karnataka, India Materials and method: This is a retrospective descriptive study done in the maternity unit of the J.J.M. Medical College Teaching Hospital, Davangere, Karnataka, India. From June 2009 to June 2011. Results: The incidence of peripartum hysterectomy during the study period was 1.0/1000 deliveries. The main indication was uterine atony 15(60%) ,severe uterine bleeding from uterine rupture 8 (32%), placenta accreta 2 (8%) and all patients received blood transfusion. 62.5% of women belonged to the 26-30 year age group and 31% belonged to the 20-25 year age group. There were 4 mortalities (8%) one patient died on 4th post-op day due to acute renal failure and the other died 2 hours after surgery due to cardiac arrest.2 died secondary to DIC. Average hospital stay of the patients was 9 days. Perinatal loss occurred in 14 cases (56%), majority due to pulmonary haemorrhage and prematurity. Conclusions: The incidence of emergency peripartum hysterectomy is high. It is performed for young nulliparous women to elderly grand-multiparous women. The surgery is associated with significant maternal and perinatal morbidity and mortality. Timely expert management in a well resourced centre is advocated.