Review of emergency obstetric hysterectomies at a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20230533Keywords:
Atonic postpartum hemorrhage, Caesarean section, Emergency obstetric hysterectomy, Placenta previaAbstract
Background: Emergency obstetric hysterectomy refers to surgical removal of pregnant or recently pregnant uterus with the pregnancy in utero or due to complications of delivery. This surgery is usually done as a last resort in life threatening obstetric hemorrhage. Objective of present study was to determine the incidence, sociodemographic and obstetric factors and indications associated with emergency obstetric hysterectomies.
Methods: A retrospective, analytical study was conducted over a period of five years in the department of obstetrics and Gynecology of Government Medical college Thiruvananthapuram. Kerala. All cases of obstetric hysterectomy done during the study period in this hospital were analysed after getting approval from the institutional ethical committee.
Results: During the study period there were total number of 78613 deliveries in SATH. Emergency obstetric hysterectomy was done for 86 cases. Obstetric hysterectomy rate in SATH during the study period was 0.109% or 1.09/1000 deliveries. Atonic postpartum hemorrhage (55%) was the most common indication followed by placenta praevia (27%). Majority were referred cases.
Conclusions: Emergency obstetric hysterectomy can be a lifesaving procedure when other medical and surgical methods fail to control obstetric hemorrhage. This study highlights the unpredictable need of this procedure, need for identifying the at-risk cases and early referral to higher center.
References
Bateman BT, Mhyre JM, Callaghan WM. Peripartum hysterectomy in the United States: nationwide 14-year experience. Am J Obstet Gynecol. 2012;206(1):63.
Wen SW, Huang L, Liston RM, Haeman M, Baskett TF, Rusen ID. Severe maternal morbidity in Canada, 1991-2001. Can Med Assoc J. 2005;173:759-63.
Awan N, Bennett MJ, Walters WA. Emergency peripartum hysterectomy: a 10-year review at the Royal Hospital for Women, Sydney. A N Z J Obstet Gynaecol. 2011;51(3):210-5.
Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstet Gynecol. 2002;99(6):971-5.
Fatima M, Kasi PM, Baloch SN, Afghan AK. Experience of emergency peripartum hysterectomies at a tertiary care hospital in Quetta, Pakistan. Int Scholar Res Not. 2011;2011.
Imudia AN, Awonuga AO, Dbouk T, Kumar S, Cordoba MI, Diamond MP, et al. Incidence, trends, risk factors, indications for, and complications associated with cesarean hysterectomy: a 17-year experience from a single institution. Arch Gynecol Obstet. 2009;280:619-23.
Zelop CM, Harlow BL, Frigoletto FD, Jr, Safon LE, Saltzman DH. Emergency peripartum hysterectomy. Am J Obstet Gynecol. 1993;168(5):1443-8.
Kant A, Wadhwani K. Emergency obstetric hysterectomy: J Obstet Gynecol India. 2005;55:32-4.
Forna F, Miles AM, Jamieson DJ. Emergency obstetric hysterectomy. Am J Obstet Gynecol. 2004;190:1440-4.
Flood KM, Said S, Geary M, Robson M, Fitzpatrick C, Malone FD. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol. 2009;200(6):632-e1.
Temzikhan O, Angun D, Karakus R. Changing trends in emergency peripartum hysterectomy in a tertiary obstetric centre in Turkey during 2000-2013. J Turk Ger Gynecol Assoc. 2016;17(1):26-3.
Kwee A, Bots ML, Visser GH, Bruinse HW. Emergency peripartum hysterectomy: a prospective study in the Netherlands. Eur J Obstet Gynecol Reprod Biol. 2006;124(2):187-92.
Yamani Zamzami TY. Indication of emergency peripartum hysterectomy: review of 17 cases. Arch Gynecol Obstet. 2003;268(3):131-5.
Bai SW, Lee HJ, Cho JS, Park YW, Kim SK, Park KH. Peripartum hysterectomy and associated factors. J Reprod Med Obstet Gynecol. 2003;48(3):148-52.
