DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20195354

A study on peripartum hysterectomy in a tertiary referral government hospital

Chaithra M., Tejeswini K. K., Savitha C.

Abstract


Background: Emergency peripartum hysterectomy (EPH) is a major surgical venture invariably performed in the setting of life-threatening haemorrhage during or immediately after abdominal and vaginal deliveries. Aim of the study was to study the frequency and indications for peripartum hysterectomy and to assess the maternal outcome of peripartum hysterectomy.

Methods: Cross sectional study was done in the department of obstetrics and gynaecology, Vanivilas hospital, Bangalore from September 2018 to august 2019. This study consists of 24 cases of emergency peripartum hysterectomy within 24 hours of delivery, operated at Vanivilas hospital.

Results: The frequency of peripartum hysterectomy was 1.102/1000 deliveries and following caesarean section and vaginal deliveries are 3.544/1000 deliveries and 0.248/1000 deliveries respectively. Among 24 cases who had peripartum hysterectomy, 16 cases were delivered by caesarean section and 4 cases delivered by vaginal route while another 4 cases delivered by laparotomy for rupture uterus. 22 cases (91.67%) survived with major number of cases having morbidities and there were 2 (8.33%) maternal death.

Conclusions: The most common mode of delivery before peripartum hysterectomy was Caesarean section. The most common indication was atonic postpartum haemorrhage. Better protocols for induction and augmentation of labour will decrease the necessity of peripartum hysterectomies.


Keywords


Atonic postpartum hemorrhage, Emergency peripartum hysterectomy, Laparotomy, Placental site bleeding, Traumatic postpartum hemorrhage

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References


Christopoulos P, Hassiakos D, Tsitoura A, Panoulis K, Papadias K, Vitoratos N. Obstetric hysterectomy.A review of cases over 16 years. J Obstet Gynecol. 2011;31(2):139-41.

Kwee A, Boto ML, Visser GH, Bruinse HW. Emergency peripartum hysterectomy: a prospective study in The Netherlands. Eur J Obstet Gynecol Reprod Biol. 2006;124(2):187-92.

Karayalcin K, Ozcan S, Ozyer S, Mollamahmutoglu L, Danisman N. Emergency peripartum hysterectomy. Arch Gynecol Obstet. 2010;283(4):723-7.

El Jallad MF, Zayed F, Al-Rimawi HS. Emergency peripartum hysterectomy in Northern Jordon: indications and obstetric outcome (an 8-year review). Arch Gynecol Obstet. 2004;270(4):271-3.

Zamzami TY. Indications of emergency peripartum hysterectomy: review of 17 cases. Arch Gynecol Obstet. 2003;268(3):131-5.

Daskalakis GE, Anastasakis N, Papantoniou S, Mesogitis M, Theodora, Antsaklis A. Emergency obstetric hysterectomy. Acta Obstetricia Gynecologica Scandinavica. 2007;86(2):223-7.

Parro E. Dell amputazione utero-ovarica come complement di taglio cescareo. Ann leniv Med chir. Clin Obstet Gynecol. 1969;12(3):575-89.

Park EH, Sachs BP. Postpartum haemorrhage and other problems of third stage, in high risk pregnancy management options. 2nd edition. W.B. Saunders, Philadelphia, USA. 1999:1231-46.

Engelsen IB, Albrechtsen S, Iversen OE. Peripartum hysterectomy incidence and maternal morbidity. Acta Obstet Gynecol Scand. 2001;80(5):409-12.

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

Sheiner E, Levy A, Katz M, Mazor M. Identifying risk factor for peripartum cesarean hysterectomy. A population based study. J Reprod Med. 2003;48(8):622-6.

Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum: experience at a community teaching hospital. Obstet Gynecol. 2002;99:971-5.

Bakshi S, Meyer BA. Indications for and outcome of emergency peripartum hysterectomy. A five year review. J Reprod Med. 2000;45(9):733-7.

Zelop CM, Harlow BL, Frigoletto FD, Safon LE, Saltzman DH. Emergency peripartum hysterectomy. Am J Obstet Gynecol. 1993;168:1443-8.

Stanco LM, Schrimmer DB, Paul RH, Mishell DR. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol. 1993;168(3):879-83.

Kerr JM, Baskett TF, Calder AA. Kumaran SA. Operative obstetric. 11th edition.2007:175-180.

Mousa HA, Alfirevic Z. Treatment for PPH. Cochrane Database Syst Rev. 2007;(1):CD003249.

Carvalho JF, Cubal A, Torres S, Costa F, Carmo CO. Emergency peripartum hysterectomy: a 10-year review. ISRN Emergency Medicine. 2012;72:191-8.

Sharma B, Sikka P, Jain V, Jain K, Bagga R, Suri V. Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomes. JOACP. 2017;33(3):324-8.