Study of maternal outcome in emergency peripartum hysterectomy at a tertiary hospital


  • Varalakshmi K. Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, R.N.T. Medical College, Udaipur, Rajasthan, India
  • Radha Rastogi Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, R.N.T. Medical College, Udaipur, Rajasthan, India
  • Neha Choudhary Department of Obstetrics and Gynecology, Panna Dhaya Zanana Hospital, R.N.T. Medical College, Udaipur, Rajasthan, India



Atonic PPH, Maternal mortality, Peripartum hysterectomy, Rupture uterus


Background: Emergency peripartum hysterectomy is an indispensable part of the obstetricians' armamentarium. In no other gynecological or obstetrical surgery, is the surgeon in as much a dilemma as when deciding to resort to an emergency hysterectomy. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times, it is a very difficult decision and requires good clinical judgment. Objective of present study was to study the cases of emergency peripartum hysterectomy performed in tertiary care center to estimate the incidence, indications, and maternal outcome following the procedure.

Methods: All cases of peripartum emergency hysterectomy that were performed in our hospital from January 2015 to June 2016 were reviewed and evaluated in terms of the incidence, indications, and the associated complications.

Results: During the study period there were 28 emergency peripartum hysterectomies out of 28215 deliveries giving an incidence of 0.10%. rupture uterus was the Commonest indication contributing to 13 cases. Septicemia was the common post operative complication associated. There were 4 maternal deaths in our study.

Conclusions: Emergency peripartum hysterectomy though a rare operation, still remains a life‑saving procedure with which every obstetrician must be conversant. regular antenatal care, identification of high‑risk cases, and prompt referral can reduce the incidence of this operation. Peripartum hysterectomy will always remain an essential life saving surgery for the mother at cost of their uterus and when performed in indicated cases at right time will help in bringing down maternal mortality.


Sturdee DW, Rushton DL. Cesarean and post partum hysterectomy. Br J Obstet Gynecol. 1986;93:270-74.

Mantri L, Maheshwari K, Chandra. Emergency Hysterectomy a ten years review. J Obstet Gynecol India. 1995;43:936-9.

Lamba J, Gupta S. Role of emergency hysterectomy in modern obstetrics. JK Sci. 2012;14(1):22.

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

Glaze S, Ekwalanga P, Roberts G, Lange I, Birch C. Peripartum Hysterectomy: 1999 To 2006. Obstet Gynecol. 2008;111:732-8.

O’Driscoll K, Meagher D, Robson M. Active Management of Labour: The Dublin Experience. 4th ed. London: Mosby; 2004.

Ofir K, Sheiner E, Levy A, Katz M, Mazor M. Uterine rupture: risk factors and pregnancy outcome. Am J Obstet Gynecol. 2003;189:1042-6.

Kwee ML, Bots GHA, Visser, ruinse HW. Emergency peripartum hysterectomy: a prospective study in the Netherlands. Euro J Obstet Gynecol Reprod Biol. 2006;124(2):187-192.

Ara S, Umbreen, Fouzia. Emergency obstetric hysterectomy. Professional Med J. 2015;22(1):100-5.

Kwee A, Bots ML, Visser GH, Bruinse HW. Uterine rupture and its complications in Netherlands: a prospective study. Eur J Obstet Gynecol Reprod Biol. 2006;128:257-61.

Malik HS. Frequency predisposing factors and fetomaternal outcome in uterine rupture. J Coll Physicians Surg Pak. 2006;16:472-5.

Wani S, Fareed P, Gull Y, Mahajan N. Emergency peripartum hysterectomy: incidence, indications and fetomaternal outcome in a tertiary care hospital. Int J Curr Res Rev. 2016 Feb 1;8(3):7.

Sikora-Szczęśniak DL, Szczęśniak G, Szatanek M, Sikora W. Clinical analysis of 52 obstetric hysterectomies. Ginekologia Polska. 2016;87(6):460-6.

Nooren M, Nawal R. Obstetric hysterectomy: a life saving emergency. Indian J Med Sci. 2013;67(5&6):2013.

Sarojini A. Clinical study of emergency peripartum hysterectomy postpartum hemorrhage. International journal of reproduction, contraception, obstetrics and gynecology. Int J Reprod Contracept Obstet Gynecol 2016 Apr; 5(4):1171-3.

Lovina SM. Machado, emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. N Am J Med Sci. 2011;3(8):358-361.

Sharma R, Shaheen, Pathak J. Peripartum hysterectomy review of 70 cases. South Asian Federation Obstet Gynecol. 2009;1(2):19-21.

Nohira T, Onodera T, Isaka K. Emergency postpartum hysterectomy: incidence, trends, indications and complications. Hypertens Res Pregnancy. 2014;2:88-93.

Vijayan A, Saraswathi. Review of peripartum hysterectomy cases in five years. IOSR-JDMS. 2015;14(10):1-4.

Agrawal S. Peripartum hysterectomy in a teaching hospital in India. Asian J Med Sci. 2014 Jul 1;4(1):5-9.

Wakhloo A, Zarfashian A, Gupta S. A study of various factors associated with peripartum hysterectomy. JK Sci. 2016;18(1).

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

Rathod AD, Pajai SP. Emergency obstetric hysterectomies at a tertiary referral Shri Vasantrao Naik Government Medical College and hospital of tribal of Yavatmal district (Maharashtra): retrospective critical analysis (6 years study). J South Asian Feder Obst Gynecol. 2015;7(2):55-60.

Kashika, Gaikwad H. Broad ligament hematoma after spontaneous vaginal delivery: a case report. IOSR-JDMS. 2016;15(7):52-53.

Chanrachakul B, Chaturachinda K, Phuspradit W, Roungsipragarn R. Cesarean and post partum hysterectomy. Int J Gynecol Obstet. 1996;54(2):109-113.

Ashraf S, Gul Y, Malla MS, Mohi-ud-Din Regoo F. Emergency peripartum hysterectomy at a tertiary care hospital in Kashmir valley. J Evol Med Dental Sci. 2015;4(3):400-7.

Ahmad S, Mir I. Emergency peripartum hysterectomy: experience at apex hospital of Kashmir valley. Internet J Gynecol Obstet. 2006;8(2):1-4.






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