Obstetric hysterectomy: aretrospective study at a tertiary care centre
Keywords:
Obstetric hysterectomy, Postpartum haemorrhage, Rupture uterus, Previous caesarean sectionAbstract
Background: To analyzethe cases of Obstetric Hysterectomy in view to evaluate the incidence, indication, maternal risk factors and complications associated with the surgery.
Methods: Retrospective Observational analytical study of cases of obstetric hysterectomy performed at Obstetrics and Gynecology department of People’s Medical College and Research Centre, Bhanpur, Bhopal over a period of seven years was done. Evaluation of Maternal age, parity, gestational age, indication for hysterectomy, the type of operation performed, blood loss, blood transfused, complications, and hospitalization period was done.
Results: The overall incidence of Obstetric hysterectomy in our study was found to be 0.33%, with a maximum number of patients 7 (33%) inthe age groupof 26-30 yrs.Patients who were para 3 or more were -12 (63%). The causes for an obstetric hysterectomy werePPH – 12 (63%); placenta previa – 5 (26%); ruptured uterus – 4 (21%). 9(47%) patients had a history of previous caesarean section. Out of the 19 hysterectomies performed, 12(63%) were total hysterectomy and 7(37%) were subtotal hysterectomy. Fever was the commonest complication 7(37%). There were two maternal deaths.
Conclusions: Obstetric hysterectomy is a lifesaving procedure. The outcome depends on timely decision, good clinical judgement and professional surgical technique. It reduces maternal morbidity and mortality.
Metrics
References
McNulty JV. Elective caesarean hysterectomy - revisited. Am J Obstet Gynaecol 1984; 149: 29-32.
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.
Anita K, Kavita WW. Emergency obstetric hysterectomy. J Obstet Gynecol India2005 Mar-Apr; 55(2): 132-4.
Chestnut DH, Eden RD, Gall SA, Parker RT. Peripartum hysterectomy: A review ofcesarean and postpartum hysterectomy. Obstet Gynecol 1985; 65:365-70.
Zelop CM, Harlow BL, Frigoletto FD, Safon LE, Saltzman Dh. Emergency peripartum hysterectomy.Am J Obstet Gynecol 1993; 168:1443-1445.
Korejo R, Bhutta S, Nasir A,Yasmin H. Emergency Obstetric Hysterectomy.JPMA 62:Dec 2012;1322-1325.
Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH. Emergency hysterectomy for obstetrical hemorrhage. Obstet Gynecol 1984; 64: 376-80.
Agashe A P, 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.
Vázquez JA, Rivera GV, Higareda SH, Páez 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, et al. 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 Obstetric hysterectomy. J Obstet Gynecol India 2004;54:343-5.