PERIPARTUM HYSTERECTOMY- A RETROSPECTIVE ANALYSIS

Abstract

Background: Peripartum hysterectomy (PH) is the removal of the uterus performed in obstetrical complications such as irreparable uterine rupture, uncontrolled postpartum hemorrhage (PPH) and placenta accrete syndrome. In spite of increased medical facilities its incidence has increased in recent years. Methods: A retrospective analysis of 20 cases of peripartum hysterectomy performed from January 2014 to June 2021 was done. The total numbers of caesarean and vaginal deliveries were recorded. Main outcome measures were the incidence, indication, management option used, maternal and fetal outcome. Results: There were a total of 6824 deliveries; 3901 vaginal and 2923 caesarean sections. Atotal of 20 patients underwent PH. The incidence of PH in our study was 2.9/1000 total deliveries and 6.8 /1,000 caesarean births. The main indication was rupture uterus with total of 10 cases (50%). Majority of cases 13 (65%) were in the age group of 20-30years and 17 (85%) were unbooked. 17 (85%) cases were referred from peripheral centers. All women who had uterine rupture were referrals from other centers. Intensive care management was required in 17(85%) women postoperatively. The common maternal complications were febrile morbidity, bladder injury, and surgical site infection. There was no maternal mortality. But neonatal mortality was in 10 cases (50%). The average period of hospital stay was 10 days. Conclusion: The most common indication for peripartum hysterectomy was rupture uterus. Correct assessment with quick intervention with a multidisciplinary team approach is the main key to prevent maternal mortality and morbidity.