Emergency peripartum hysterectomy: a retrospective study of 7 years

Suchith Hoblidar, Sunil Kumar K. S., Ratnamala M. Desai


Background: Emergency peripartum hysterectomy (EPH) is a rare but a lifesaving procedure done as a last resort to save life of mother. We conducted this study to know the incidence, leading causes, risk factors and complications of EPH.

Methods: We conducted a retrospective analysis of all the patients who underwent EPH from January 2008 to December 2015 at SDMCM and H. All patients who underwent EPH from 22 weeks of gestation to 6 weeks postpartum were included in the study.

Results: There were 21 emergency peripartum hysterectomies, with deliveries during the same period being 27271 and the rate of EPH was 0.7 per 1000 deliveries. Most common indication for EPH was uterine atony (38%), followed by uterine rupture (23.8%) and morbidly adherent placenta (19%). Most of the patients (47.6%) had previous cesarean deliveries. EPH was done following cesarean in 66.6%. Subtotal hysterectomy was done in 61.9%. Intra-operative urinary bladder injury was seen in 14.2% of the patients.

Conclusions: Uterine atony and uterine rupture continues to be the most common causes for EPH in our population. Multiparity is an important risk factor among patients with rupture uterus. Cesarean delivery and repeat cesarean deliveries are the likely risk factors for EPH.


Emergency peripatum hysterectomy, Previous cesarean, Uterine rupture

Full Text:



Lovina SM. Machado. Emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. North American Journal of Medical Sciences. 2011;3(8):358-61.

Chawla J, Arora CD, Ajmani SN. Emergency Obstetric hysterectomy: a retrospective study from a teaching hospitalin North India over eight years. Oman Med J. 2015;30(3):181-6.

Say L, Chou D, Gemmill A, Tnncalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33.

Cameron CA, Roberts CL, Olive EC, Ford JB, Fischer WE. Trends in postpartum hemorrhage. Aust N Z J Public Health. 2006;30(2):151-6.

Tuncalpo O, Hindin MJ, Souza JP, Chou D, Say L. The prevalence of maternal near miss: a systematic review. BJOG. 2012;119(6):653-61.

Carvalho JF, Cubal A, Torres S, Costa F, da Carmo O. Emergency peripartum hysterectomy: a 10- year review. International Scholarly Research Network Emergency Medicine, 2012. Available at

Flood KM, Said S, Geary M, Robson M, Fitzpatrick C, Malone FD. Changing trends in peripartum hysterectomy over last 4 decades. Am J Obstet Gynecol. 2009;200:632.e1-632e6.

Forna F, Miles AM, Jamieson DJ. Emergency peripartum hysterectomy: a comparision of cesarean and postpartum hysterectomy. Am J of Obstetrics and Gynecology. 2004;190:1440-4.

Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstetric and Gynecology. 2002;99(6):971-5.

Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH. Emergency hysterectomy for obstetric hemorrhage. Obstet Gynecol. 1984;64:376-80.

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

Chester J, Sindhu P, Sharma S, Israfil-Bayli F. Emergency peripartum hysterectomy at a district general hospital in United Kingdom: 10-Year Review of Practice. 2016;2016:Article ID9875343:4.

Whiteman MK, Kuklina E, Hillis SD, Jamieson DJ, Meikle SF, Posner SF, et al. Incidence and determinants of peripartum hysterectomy. Obstet Gynecol. 2006;108(6):1486-92.

Saxena SV, Bagga R, Jain V, Gopalan S. Emergency peripartum hysterectomy. International Journal of Gynecology and Obstetrics. 2004;85:172-3.

Najam R, Bansal P, Sharma R, Agarwal D. Emergency obstetric hysterectomy: a retrospective study at a tertiary care hospital. Journal of Clinical and Diagnostic Research. 2010;(4):2864-8.

Chanrachakul B, Chaturachinda K, Phuspradit W, Roungsipragarn R. Cesarean and postpartum hysterectomy. Int J Gynecol Obstet. 1996;54(2):109-13.