Emergency Obstetric Hysterectomy At A Tertiary Care Hospital

Farhana Shaikh, Fehmida Parveen Memon, Najma Bano Shaikh, Sajida Yousfani, Farhat Sultana, Samina Shaikh

Abstract

Objective

To determine the frequency, indications and maternal complications associated with emergency obstetric hysterectomy.

Study design

Retrospective observational study.

Place & Duration of study

Department of Obstetrics & Gynecology unit 1, Liaquat University of Medical & Health Sciences (LUMHS) Jamshoro, from January 2019 to December 2019.

Methodology

All patients who underwent obstetric hysterectomy were studied in detail for age, parity, history of previous cesarean section, indications, and maternal complications associated with obstetric hysterectomy. Data were collected from the hospital record and statistical analysis was done by SPSS version 18.0.

Results

During the study period, 36 women underwent obstetric hysterectomy. The frequency of obstetric hysterectomy was 6.9/1000 or 0.69%. Thirteen (36.11%) women were 30-35 years of age, 27 (75%) were para 3 and above. In 18 (50%) women hysterectomy was performed because of atonic uterus, in 9 (25%) due to morbidly adherent placenta and in 4 (11.11%) with uterine rupture. Frequently observed clinical features were anemia in 5 (13.88%), hypovolemic shock in 4 (11.11%), and bladder injury in 4 (11.11%). There were 4 (11.11 %) maternal deaths in this series.

Conclusion

The high frequency of obstetric hysterectomy is found with multiparty, atonic uterus, previous cesarean section and morbidly adherent placenta. Maternal mortality was more than 10% which is alarming.

Key words

Obstetric hysterectomy, Multipara, Atonic uterus, Cesarean section, morbidly adherent placenta.