DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182900

Obstetric hysterectomy: analysis of 50 cases at a tertiary care hospital

Niranjan M. Mayadeo, Girija Swaminathan

Abstract


Background: Despite advances in modern medical sciences, there is a plethora of morbidity which continues to affect women during childbirth, necessitating removal of the uterus in the peripartum or postpartum period. This study analyses 50 cases of obstetric hysterectomy done in a single institute.

Methods: After Institutional Ethics Committee approval, a retro prospective analysis of hospital records of 50 cases of obstetric hysterectomy was done over a five year period in the department of obstetrics and gynaecology at a tertiary care referral centre-KEM hospital.

Results: During the study period, there were 50 cases of obstetric hysterectomy out of 43839 deliveries giving an incidence of 0.12%. Mean age of women undergoing obstetric hysterectomy was 29.9 years. 86% of these were multiparous. The most common indication was morbidly adherent placenta (38%) followed closely by followed by rupture uterus (34%) and uterine atony (20%). Total hysterectomy was the most preferred type of hysterectomy (74%). Urinary tract injury and hypovolemic shock were the most frequently encountered complications. The maternal mortality rate in our study was 4%. 86% of the babies born had Apgar score of 9/10. 44% of babies required admission to neonatal intensive care unit.19.6% of the patients had still born babies and there were 4 neonatal deaths.

Conclusions: Obstetric hysterectomy is associated with increased risk of maternal and perinatal morbidity and mortality.


Keywords


Lifesaving, Morbidly adherent placenta, Maternal morbidity, Obstetric hysterectomy

Full Text:

PDF

References


Korejo R, Bhutta S, Nasir A, Yasmin H. Emergency Obstetric Hysterectomy. JPMA. 2012;62:1322-5.

Bhat S, Bhave S. Obstetric Hysterectomy a life saving procedure and its complication. Int J Med Dent Sci. 2016;5(1):996-1001.

Chawla J, Arora D, Paul M. emergency obstetric hysterectomy: a retrospective study from a teaching hospital in North India over Eight Years. Oman Medical J. 2015;30:181-6.

Bateman BT, Mhyre JM, Callaghan WM, Kuklina EV. Peripartum hysterectomy in the United States: nationwide 14 year experience. Am J Obstet Gynecol. 2012;206:63.1-8.

Owolabi MS, Blake RE, Mayor MT. Incidence and determinants of peripartum hysterectomy in the metropolitan area of the District of Columbia. J Reprod Med. 2013;58(3-4):167-72.

Brobbel C, Dekkers OM, Bloemenkamp KW. Prevalence, indications, risk indicators, and outcomes of emergency peripartum hysterectomy worldwide: a systematic review and meta-analysis. Obstet Gynecol. 2016;128(6):1281-94.

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

Abasiattai A, Umoiyoho A, Utuk N, Inyang-Etoh EC, Asuquo OP. Emergency peripartum hysterectomy in a tertiary hospital in southern Nigeria. Pan Afr Medical J. 2013;15:60.

Lamba J, Gupta S. Role of Emergency Hysterectomy in Modern Obstetrics. JK Sci. 2012;14(1):22-4.

Chester J, Sidhu P, Sharma S, Israfil-Bayli F. Emergency Peripartum Hysterectomies at a District General Hospital in United Kingdom: 10-Year Review of Practice. Hindawi Publishing Corporation Scientifica. 2016;2016:ID 9875343.

Allam IS, Gomaa IA, Fathi HM. Incidence of emergency peripartum hysterectomy in Ain-shams University Maternity Hospital, Egypt: a retrospective study. Arch Gynecol Obstet. 2014;290(5):891-6.

Juneja SK, Tandon P, Mohan B, Kaushal S. A change in the management of intractable obstetrical hemorrhage over 15 years in a tertiary care center. Int J Appl Basic Med Res. 2014;4(1):17-9.

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

Shah S, Pardeshi S, Warke HS. Obstetric Hysterectomy: A Life Saving Measure For Puerperal Sepsis. JPGO. 2016;3(11).

Wani RV, Abu-Hudra MS, Al-Tahir SI. Emergency Peripartum Hysterectomy: A 13-Year Review at a Tertiary Center in Kuwait. J Obstet Gynaecol India. 2014;64(6):403–8.

Mavrides E, Allard S, Chandraharan E, Collins P. Prevention and Management of postpartum haemorrhage. BJOG. 2016;124:106-49.

Revicky V, Muralidhar A, Mukhopadhyay S. A Case Series of Uterine Rupture: Lessons to be Learned for Future Clinical Practice. J Obstet Gynaecol India. 2012;62(6):665-73.