Emergency obstetric hysterectomy: review at a tertiary care hospital


  • Shirodker S. D. Department of Obstetrics and Gynecology, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India
  • Ankita Pandey Department of Obstetrics and Gynecology, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India
  • Sunil Yadav Department of Obstetrics and Gynecology, TNMC and BYL Nair Hospital, Mumbai, Maharashtra, India




Obstetric hysterectomy, Emergency obstetric hysterectomy, Morbidly adherent placenta


Background: The objective of the study was to study indications and maternal outcome of emergency obstetric hysterectomy.

Methods: A retrospective study of the cases of emergency obstetric hysterectomy performed over a period of 7.5years from 2008 to May 2016 in a tertiary care hospital was done. Maternal characteristics, indications, and maternal morbidity and mortality were analyzed.

Results: During the study period there were 45 emergency obstetric hysterectomies and 28,207 deliveries, giving an incidence of 0.16% or 1.6/1000. Majority of the cases were unbooked (55.6%). It was more common in multipara (71.1%). Ruptured uterus (37.7%) and morbidly adherent placenta (26.6%) were the common indications. the maternal mortality was 2.22%.

Conclusions: Emergency obstetric hysterectomy is a lifesaving procedure. The maternal outcome greatly depends on timely decision and good clinical judgment because unnecessary delay can cost life and undue haste can cause morbidity. 


Say L, Souza JP, Pattinson RC, 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.

Miller S, Lester F, Hensleigh P. Prevention and treatment of postpartum hemorrhage: new advances for low-resource settings. J Midwifery Womens Health. 2004;49(4):283-92.

Singhal S, Singh A, Raghunandan C, Gupta U, Dutt S. Uterine artery embolization: exploring new dimensions in obstetric emergencies. Oman Med J. 2014;29(3):217-219.

Varghese S, Gokulam N. Al-Abri S. Uterine Artery Embolization in Postpartum Hemorrhage: A Case Report. Oman Med J. 2012;27(2) .

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):e323-e333.

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

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

Durfee RB. Evolution of cesarean hysterectomy. Clin Obstet Gynecol. 1969;12(3):575-89.

Tapisiz OL, Altinbas SK, Yirci B, Cenksoy P, Kaya AE, Dede S. Emergency peripartum hysterectomy in a tertiary hospital in Ankara, Turkey: A 5-year review. Arch Gynecol Obstet. 2012;286(5):1131-4.

Knight M, UKOSS. Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage. BJOG. 2007;114(11):1380-7.

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

Kant A, Wadhwani K. Emergency obstetric hysterectomy J Obstet Gynecol India. 2005;55:132-4.

Ahmad SN, Mir IH. Emergency Peripartum Hysterectomy: Experience at apex hospital of Kashmir Valley. The internet journal of gynecology and obstet. 2007;8:2.

Marwaha P, Kaur M, Gupta A. Peripartum Hysterectomy- a five years study. J Obstet Gynecol India. 2008;58:504-6.

Flood K, Said S, Geary M. Changing trends in peripartum hysterectomy over the last 4 decades Presented at the 28th Annual Scientific Meeting of the Society for Maternal-Fetal Medicine, Dallas, TX, 2008.

Sharma R, Shaheen, Pathak J. Peripartum Hysterectomy-A review of 70 cases. South Asian Fedration of obstet and gynaecol. 2009;1(2):19-21.

Temizkan O, Angın D, Karakuş R. Changing trends in emergency peripartum hysterectomy in a tertiary obstetric center in Turkey during 2000–2013. J Turk Ger Gynecol Assoc. 2016;17(1):26-34.

Greer I, Lang G, Patel N. The Management of Postpartum Haemorrhage. Aberdeen: Scottish Obstetric Guidelines and Audit Project. 1998.

Roopnarinesingh R, Fay L, McKenna P. A 27-year review of obstetric hysterectomy. J Obstet Gynaecol. 2003;23(3):252-4.

Langdana F, Geary M, Haw W, Keane D. Peripartum hysterectomy in the 1990s: any new lessons? J Obstet Gynaecol. 2001;21(2):121-3.

Umezurike CC, Feyi-Waboso PA, Adisa CA. Peripartum hys- terectomy in Aba southeastern Nigeria. Aust N Z J Obstet Gynaecol. 2008;48:580-2.

Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin G, Kamaci M. Peripartum hysterectomy in a teaching hospital in the eastern region of Turkey. Eur J Obstet Gynecol Reprod Biol. 2005;120:57-62.

Yalcinkaya A, Guzel AI, Kangal K. Emergency peripartum hysterectomy: 16-year experience of a medical hospital. J Chin Med Assoc. 2010;73:360-3.

Demirci O, Tugrul AS, Yilmaz E, Tosun O, Demirci E, Eren YS. Emergency peripartum hysterectomy in a tertiary obstetric center: nine years evaluation. J Obstet Gynaecol Res. 2011;37:1054-60.

Publications Committee, Society for Maternal-Fetal Medicine. Belfort MA. Placenta accreta. Am J Obstet Gynecol. 2010;203:430-9.

Ding DC, Hsu S, Chu TW, Chu TY. Emergency peripartum hysterectomy in a teaching hospital in Eastern Taiwan. J Obstet Gynaecol. 2006;26:635-8.

Seffah JD. Re-laparatomy after cerarean section. Int J Gynaecol Obstet. 2005;88:253-7.

Knight M, Callaghan WM, Berg C, Alexander S, Bouvier-Colle MH, Ford JB. Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth. 2009;9:55.






Original Research Articles