Introduction: Emergency peripartum hysterectomy is a life-saving procedure performed as an emergency procedure to control torrential bleeding and it is associated with significant maternal morbidity and mortality. There are only a few studies regarding this topic so this study guides us to monitor the trend and start appropriate policies to reduce unnecessary caesarean deliveries. The aim of this study was to find out the prevalence of peripartum hysterectomy among patients admitted to the Department of Obstetrics and Gynaecology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of the tertiary care centre. Data from 1 January 2015 to 31 December 2022 were collected between 25 January 2023 and 28 February 2023 from the hospital records. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 2301241700). Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 54,045 deliveries, peripartum hysterectomy was seen in 40 (0.074%) (0.05-0.10, 95% Confidence Interval). The major indication of emergency peripartum hysterectomy was abnormal placentation (placenta accreta spectrum) which was 25 (62.50%) followed by uterine atony in 13 (32.50%) of patients and uterine rupture in 2 (5%). Conclusions: The prevalence of peripartum hysterectomy was lower than in other studies done in similar settings. The indication for Emergency peripartum hysterectomy has changed in recent years from uterine atonicity to the morbidly adherent placenta which is due to a rise in the caesarean section rate.
Introduction: Postpartum hemorrhage(PPH) is the leading cause of maternal mortality. The intrauterine balloon tamponade is the efficient and economical means to treat atonic PPH so this study was done to evaluate the outcome of uterine balloon tamponade in atonic PPH. Method: This was a retrospective study conducted at the Patan Academy of Health Sciences Lalitpur, Kathmandu from January 2017 to December 2019. It included women with postpartum haemorrhage due to uterine atony in whom medical treatment had failed. Result: The condom tamponade was successful in 94.7% women with uterine atony, who did not respond to uterotonic drugs and 5.3% required peripartum hysterectomy. Majority of women were in the 25-29 years age group. 73.3% were multigravida and 63.2% had vaginal delivery. No case of febrile morbidity and wound sepsis was noted. Conclusion: The study concludes the use of condom tamponade as an effective means of controlling atonic PPH. It is safe, easily available, inexpensive, minimally invasive, does not require anesthesia, easy to use and can be performed by any level of health personnel with some training.
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