Emergency Peripartum Hysterectomy: Experience at Apex Hospital of Kashmir Valley

Abstract

The aim of this study was to estimate incidence, indications and complications of peripartum hysterectomy in Apex Hospital of the Kashmir valley. We analyzed 100 cases of emergency cesarean hysterectomies performed in our hospital from January 2001 to December 2002. The incidence of emergency hysterectomy was 2.6 per thousand deliveries. Most common indication for emergency hysterectomy was uterine rupture (30%), followed by placenta previa (25%), uterine atony (21%) and placenta increta/accerta/percreta (8%). Majority of uterine rupture cases were late referrals from rural areas. The commonest postoperative complication was fever (27%), followed by lower respiratory tract infection (10%), wound infection (8%), and bladder injury (8%). Maternal mortality following emergency hysterectomy was 3%, and the cause of death was related to complications like shock, septicemia and disseminated intravascular coagulation (DIC).