Obstetric Hysterectomy a Life Saving Procedure and its Complication


Affiliations

  • Bharati Vidyapeeth Deemed University Medical College & Hospital, Department of Obstetrics and Gynecology, Sangli, India

Abstract

Background:Previously in developing countries obstetric hysterectomy was done when conservative measures fail to control the post partum hemorrhage. Now a days because of increasing incidence of cesarean deliveries incidence of placenta praevia is increasing. This is contributing as a major cause for obstetrics hysterectomy.

Objective: The purpose of the present study was to determine the incidence, indications, complications, maternal morbidity and mortality associated with emergency obstetrics hysterectomy.

Methods: Retrospective study of cases undergone obstetric hysterectomy over a period of five years were done. Maternal age, parity, indication for obstetric hysterectomy, risk factors, type of operation performed, additional surgeries and complications were studied.

Results: The incidence of emergency obstetric hysterectomy in our study was 0.38% [15 in 3900 deliveries]. 73.3% of the women were above 26 years. 73.3% of patients belonged to parity four or above. Majority of the cases were unbooked (60%). Postpartum hemorrhage (40%), ruptured uterus (20%) and morbidly adherent placenta (20%) were the major indications for obstetric hysterectomy. Previous LSCS was a major risk factor as it is seen in 40% cases. In 66.7% cases total hysterectomy was performed. Fever was the most common complication seen in 26.6% cases. One (6.7%) patient had maternal mortality.

Conclusion: Proper antenatal care and early referral can prevent this catastrophic event. Moreover, timely decision, liberal blood transfusion and speedy surgery by an experienced surgeon are important in the management of this life saving procedure to avoid complications.


Keywords

Obstetric Hysterectomy, Post Partum Hemorrhage (PPH), Placenta Praevia, Lower Segment Caesarean Section (LSCS), Ruptured Uterus, Accidental Haemorrhge (APH).

Subject Discipline

Obstetrics and Gynaecology

Full Text:

References

Korejo R, Bhutta S, Nasir A, Yasmin H. Emergency Obstetric Hysterectomy. JPMA Dec 2012;62:1322-25.

Stanco LM, Schrimmer DB, Paul RH, Mishell DR Jr. Emergency peripartum hysterectomy and associated risk factors. Am J OBSTET Gynaecol 1993 Mar;168(3 Pt 1):879-83.

Najam R, Bansal P, Sharma R, Agrawal D. Emergency Obstetric Hysterectomy: A retrospective study at a tertiary care hospital. Journal of Clinical and Diagnostic Research 2010;4:2864-2868.

Zelop CM, Harlow BL, Frigoletto FD, Safon LE, Saltzman Dh. Emergency peripartum hysterectomy. Am J Obstet Gynecol 1993; 168:1443-1445.

Najma Bano Shaikh, Shabnam Shaikh, Jan Muhammad Shaikh Aga Khan. Maternal and Child Care Centre, Hyderabad, Liaquat University of Medical and Health Sciences Hospital, Hyderabad, Pakistan. Morbidity and mortality associated with obstetric hysterectomy. J Ayub Med Coll Abbottabad 2010;22(2)

Sinha P, De KC. A 5-year study of Caesarean hysterectomy cases. Journal of the Indian medical Association 1993;91:238-9.

Anita K, Kavita WW. Emergency obstetric hysterectomy. J of Obstet Gyneco India 2005 Mar-Apr;55(2):132-4.

Agashe AP, Marathe SS. Obstetric hysterectomy: A review of 50 cases from January 1987 to August 1990. J Obstet Gynecol India 1991;45:490-3.

Bakshi S, Meyer BA. Indications for and outcomes of emergency peripartum hysterectomy. A 5-year review. J Reprod Med 2000;45:733-7.

Francois K, Ortiz J, Harris C, Foley MR, Elliott JP. Is peripartum hysterectomy more common in multiple gestations? Obstet Gynaecol 2005;105:1369-72.

Zorlu CG, Turan C, Isik AZ, Danisman N, Mungan T, Gokmen O. Emergency hysterectomy in modern obstetric practice. Changing clinical perspective in time. Acta Obstet Gynaecol Scand 1998;77:186-90.

Vazquez JA, Rivera GV, Higareda SH, Paez FG, Vega CC, Segura AP. Obstetric hysterectomy. Incidence, indications and complications. Ginecol Obstet Mex 2008; 76(3):156-60.

Kanwar M, Sood PL, Gupta KB. Emergency hysterectomy in obstetrics. J Obstet Gynecol India 2003;53:350-2.

Siddiq N, Ghazi A, Jabbar S, Ali T. Emergency Obstetrical Hysterectomy (EOH): A Life saving procedure in obstetrics. Pakistan J surgery 2007;23(3):217-9.

Devi P, Singh RK, Singh D. Emergency Obstetrical Hysterectomy J Obstet Gynecol India 2004;54(4):343-5.


Refbacks

  • There are currently no refbacks.