English

Abstract

OBJECTIVES: To determine the incidence, risk factors, outcome, complications and the changing trends of indications for Emergency Peripartum Hysterectomy (E.P.H.), and compare the results with other reports in the literature. METHODS: A population based 5 year retrospective study of 72 cases of emergency peripartum hysterectomy was carried out using hospital database from January 2008 to December 2012 in a peripheral medical college of Eastern India. RESULTS: A total of 72 EPH were performed among 94276 deliveries with an incidence of 0.76/1000 deliveries. The incidence was more among multiparous women (69%) and highest in the age group of 20 to 29 years (77.7%). Ruptured uterus was most common indication for Emergency Peripartum Hysterectomy (52.7%).Maternal mortality was 11.11% following peripartum hysterectomy. Our study in eastern India shows a statistically significant lower incidence of peripartum hysterectomy compared to that in other parts of India (0.076% versus 0.35% deliveries; P value <0.0101). CONCLUSION: Emergency Peripartum Hysterectomy is a life saving procedure and often puts the obstetrician in a dilemma for decision making. In this rural and backward area of Eastern India, primary and post CS deliveries are associated with an increased risk of Emergency Peripartum Hysterectomy. These results are of particular concern considering the steady rise in post CS pregnancy particularly in this backward region of our country.