DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20183313

Emergency peripartum hysterectomy: a retrospective analysis in a tertiary care hospital in Jharkhand, India

Megha Bhagat, Bratati Moitra

Abstract


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, and complications of obstetric hysterectomy.

Methods: Authors conducted a retrospective analysis of all the patients who underwent emergency peripartum hysterectomy from January 2015 to December 2017 at RIMS, Ranchi.

Results: There were 126 emergency peripartum hysterectomies, with deliveries during the same period being 21732 and the rate of EPH was 5.7 per 1000 deliveries. Most common indication for EPH was uterine rupture (54.6%), followed by uterine atony (18.2%) and morbidly adherent placenta (23.01%). Most of the patients (66.67%) had previous cesarean deliveries. EPH was done following cesarean in 66.67%. Subtotal hysterectomy was done in 88.09%. Intra-operative urinary bladder injury was seen in 11.11% of the patients.

Conclusions: Uterine rupture and Morbidly adherent placenta 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.


Keywords


Emergency peripartum hysterectomy, Previous cesarean, Uterine rupture

Full Text:

PDF

References


Lovina SM. Machado. Emergency peripartum hysterectomy: incidence, indications, risk factors and outcome. North Am J Med Sci. 2011;3(8):358-61.

Chawla J, Arora CD, Ajmani SN. Emergency Obstetric hysterectomy: a retrospective study from a teaching hospital in 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):323-33.

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.

Tunçalp Ö, Hindin MJ, Souza JP, Chou D, Say L. The prevalence of maternal near miss: a systematic review. Int J Obstetr Gynaecol. 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 http://www.hindawi.com/journals/isrn/2012/721918/.

Anuradha C, Vani JY, Aruna V. Emergency peripartum hysterectomy – one year study in labour ward Obstetrics and Gynaec department Guntur Medical College, Guntur. (2014). IOSR J Nursing Health Science (IOSR-JNHS). 2014;4(2)Ver.II:26-8.

Pandher DK, Sehgal A, Aggarwal N. Frequency, indications and maternal outcome in obstetric hysterectomy in a tertiary care centre in India. JK Science. 2015;17(1):8-12.

Abha S, Shrivastava C. Uterine Rupture: Still a Harsh Reality. J Obstet Gynecol India. 2015;65(3):158-61.

Abiodun O, Hassan O. Emergency peripartum hysterectomy in a developing country. J Obstet Gynaecol Can. 2012;34(10):954-60.

Archana K, Sahay PB. A clinical review of emergency obstetric hysterectomy. J Obstet Gynaecol India. 2009;59:427-31.

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

Singh R, Nagrath A. Emergency obstetric hysterectomy-a retrospective study of 54 cases over a period of 5 years. J Obstet Gyneco India. 2005;55:428-30.

Nazam R, Bansal P, Sharma R, Agrawal D. Emergency obstetrics hysterectomy: a retrospective study at a Tertiary Care Hospital. J Clin Diagn Res. 2010;(4):2864-8.

Shirodker SD, Pandey A, Yadav S. Emergency obstetric hysterectomy: review at a tertiary care hospital. Int J Reprod Contracept Obstetr Gynecol. 2016;5(11):3811-4.

Patil R, Dave A. Emergency Peripartum hysterectomy: a retrospective study at a tertiary care hospital. Int J Reprod Contracept Obatet Gynecol. 2016;5(5):1322-6.

Sharma B, Saxena N, Gupta V. A retrospective study of emergency obstetric hysterectomy in a tertiary care center for a period of 5 years. Int J Reprod Contracept Obstet Gynecol. 2016;5(11): 3778-81.

Kittur S, Swetha D. Emergency peripartum hysterectomy- a study in tertiary care center and medical college in Hubli, North Karnatka, India. Int J Reprod Contracept Obstet Gynecol. 2016;5(4):1097-1101.

Kant A, Nadhwani K. Emergency Obstetric hysterectomy. J Obstet Gynecol India. 2005;55(2):132-4.

Hoblidar S, KS Sunil, DM Ratnamala.Emergency peripartum hysterectomy: a retrospective study of 7 years. Int J Reprod Contracept Obstet Gynecol.2016;5(9):3112-3115.