Emergency obstetric hysterectomy in a tertiary referral centre: 10 years retrospective cross-sectional study

Authors

  • Nalini Sharma Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences Shillong, Meghalaya, India
  • Kothuni Christina Chakre Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences Shillong, Meghalaya, India
  • Purnima Singh Department of Obstetrics and Gynecology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences Shillong, Meghalaya, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20251984

Keywords:

Cesarean hysterectomy, Emergency hysterectomy, Grand-multiparous, Placental accreta spectrum, Post-partum hemorrhage, Post-partum hysterectomy, Uterine rupture

Abstract

Background: Emergency obstetric hysterectomy (OH) is the last resort opted to save life of a mother in critical obstetric conditions compromising her future reproductive potential but is a considered a lifesaving procedure in an emergency obstetric situation. We sought to study the socio-demographic factors, incidence, clinical risk factors, indications, complications and feto-maternal outcomes associated with emergency obstetric hysterectomy.

Methods: This was a retrospective study. All cases of emergency hysterectomy were reviewed from various medical record section for a period of 10 years conducted at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Results: There were 23 cases of emergency obstetric hysterectomy. The incidence of the study was 0.18%. 43.4% were grand-multiparous. Most common associated risk factor was previous caesarean section and grand-multiparous patient. The most common indication associated with OH was found to be postpartum hemorrhage. Majority (91%) of the patient received one or more blood product. The most common maternal outcome was need of ICU care. Maternal mortality was noted to be 8.7%.

Conclusions: Adequate antenatal care, screening and counselling of high-risk pregnancies, avoidance of un-indicated caesarean section, counselling for family planning methods, anticipation and timely intervention are the key to prevent and reduce maternal/neonatal mortality and morbidity.

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References

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):323-33.

Archana S, Syamala O. Obstetric hysterectomy- an analysis. Indian J Obstet Gynaecol Rese. 2018;5(4):563-6.

Anita K, Kavita WW. Emergency obstetric hysterectomy. J Obstet Gynecol India. 2005;55:132-4.

Kalyankar VY, Nimbalkar RJ, Kalyankar BV, Gadappa SN. Comprehensive study of obstetric hysterectomy. N Indian J OBGYN. 2023;10(1):88-92.

Van den Akker T, Brobbel C, Dekkers OM, Bloemenkamp KW. Prevalence, indication, risk factors and outcomes of emergency peripartum hysterectomy worldwide: a systemic review and meta-analysis. Obstet Gynecol. 2016;128:1281-94.

Huque S, Robert I, Fawole B, Chaudhri R, Arulkumaran S, Shakur-Still H. Risk factors for peripartum hysterectomy among women with postpartum hemorrhage: analysis of data from the WOMAN trial. BMC Pregnancy Childbirth. 2018;18:186.

Rossi AC, Lee RH, Chmait RH. Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systemic review. Obstet Gynecol. 2010;115:637-44.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet. 2014;2(6):323-33.

Say L, Souza JP, Pattinson RC. The WHO working group on maternal mortality and morbidity classifications, maternal near-miss-towards a standard tool for monitoring quality of maternal health care. Best Pract Res Clin Obstet Gynaecol. 2009;23(3):287 96.

Angelini CR, Pacagnella RC, Parpinelli MA, Silveira C, Andreucci CB, Ferreira EC, et al. Quality of life after an episode of severe maternal morbidity: evidence from a cohort study in Brazil. BioMed Res Int. 2018;2018:10.

Kore S, Potwar S, Tamboli J. Obstetric hysterectomy: analysis of 34 cases. J Obstet Gynecol India. 2001;51:111-4.

Satia MN, More MV. Obstetric hysterectomy: An emergency lifesaving procedure. Int J Reprod Contracept Obstet Gynecol. 2016;5(7):2338-42.

Kamble SN, Jamdade YM. Obstetric hysterectomy: a retrospective study. Int J Reprod Contracept Obstet Gynecol. 2021;10(12):4522-6.

Najam R, Bansal P, Sharma R, Agrawal D. Emergency obstetric hysterectomy: a retrospective study at a tertiary care hospital. J Clin Diagn Res. 2010;4:2864-8.

Bhat S, Bhave S. Obstetric hysterectomy a lifesaving procedure and its complications. Int J Med Dent Sci. 2016;5(1):996-1000.

Singh R, Nagrath A. Emergency obstetric hysterectomy-a retrospective study of 51 cases over a period of 5 years. J Obstet Gynecol India. 2005;55(5):428-30.

Silver RM, Landon MB, Rouse DJ, Leveno KJ, Spong CY, Thom EA, et al. Maternal morbidity associated with multiple repeat cesarean deliveries. Obstet Gynecol. 2006;107:1226-32.

De la Cruz CZ, Thompson EL, O’Rourke K, Nembhard WN. Cesarean section and the risk of emergency peripartum hysterectomy in high-income countries: a systematic review. Arch Gynecol Obstet. 2015;292(6):1201-15

Stanco LM, Schrimmer DB, Paul RH, Mishell DR. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol. 1993;168(3)879-83.

Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012;207(1):14-29.

Timor-Tritsch IE, Monteagudo A. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Am J Obstet Gynecol. 2012;207(1):14-29.11

Machado LSM. Emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. N Am J Med Sci. 2011;3(8):358-61.

Hota PJ, Swain S. Emergency obstetric hysterectomy: a retrospective study in BBMCH Balangir over one year. Int J Adv Res. 2019;7(2):306-10.

Chawla J, Arora D, Paul M, Ajmani SN. Emergency obstetric hysterectomy: a retrospective study from a teaching hospital in North India over eight years. Oman Med J. 2015;30(3):181-6.

Mukherjee S, Agarwal L, Dahiya S, Amrin S, Singh P. A retrospective study of obstetric hysterectomy in a tertiary care hospital. Int J Med Sci Public Health. 2016;5(8):1-3.

Jayaram S, Varghese AP. A clinical review of obstetric hysterectomies done in medical college, Kottayam for a period of six years. Int J Reprod Contracept Obstet Gynecol. 2016;5(2):482-6.

Wani S, Fareed P, Gull Y, Mahajan N. Emergency peripartum hysterectomy: incidence, indications and feto maternal outcome in a tertiary care hospital. IJCRR. 2016;8(3):7-10.

Jakobsson M, Tapper AM, Colmorn LB, Lindqvist PG, Klungsøyr K, Krebs L, et al. Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS). Acta Obstet Gynecol Sci. 2015;94(7):745-54.

Verma A, Sharma G, Kashyap M. A retrospective analysis of emergency obstetric hysterectomy: a life-saving intervention. Cureus 2023;15(10):e46758.

Archana K, Bala SP. A clinical review of emergency obstetric hysterectomy. J Obstet Gynecol India. 2009;59(5):427-31.

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Published

2025-06-26

How to Cite

Sharma, N., Chakre, K. C., & Singh, P. (2025). Emergency obstetric hysterectomy in a tertiary referral centre: 10 years retrospective cross-sectional study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 14(7), 2312–2316. https://doi.org/10.18203/2320-1770.ijrcog20251984

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Original Research Articles