A retrospective study of obstetric hysterectomy in a tertiary care hospital

Mukherjee, Shobha; Agrawal, Lata; Dahiya, Sonika; Amrin, Sana; Singh, Poonam

doi:10.5455/ijmsph.2016.25112015272

Cited by 2 publications

(5 citation statements)

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“…1 Amongst the recently published studies from India, the reported incidence rates range from 0.83 to 3.9 per 1000 deliveries. [5][6][7][8][9] The observations from our study are consistent with these findings, and suggest a relatively fair incidence rate; however, the number of surgeries required in 2013, was nearly two-fold higher as compared to the previous year. Of note, only a third of the cases were registered at the institute, the remaining being transferred from other centers.…”

Section: Discussionsupporting

confidence: 81%

“…The frequency of perinatal mortality is observed to be consistently high in the Indian studies. [5][6][7][8][9] Although this descriptive evidence may not suggest much regarding the possible improvements in our approach, it is always relevant to ensure high standards of maternal and fetal care, firstly to avoid this complication of postpartum hemorrhage as far as possible, and secondly, to ensure all possible measures for a successful salvage procedure, with minimal complications and more acceptable outcomes, compared to the current observations.…”

mentioning

confidence: 96%

“…Moreover, the evidence from various small studies from India and South Asia, do not suggest a consistent picture. [3][4][5][6][7][8][9] Timely decision and good surgical skills are the best components of this life saving surgery which amounts to near miss cases. A good team of anaesthetists and a well-equipped blood bank facility with round the clock availability of blood and blood products is needed to improve the worsening hemodynamic parameters and supports the patient to sustain the surgery.…”

Section: Introductionmentioning

confidence: 99%

“…This frequency is consistent with the maternal mortality reported in various Indian studies (0 to 17.7%). [5][6][7][8][9] The frequency reported from developed countries ranges from 0-16.7%, with an average rate of 3%. Intrauterine fetal deaths occurred in one-fifth of the cases.…”

mentioning

confidence: 99%

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Obstetric hysterectomy: an emergency lifesaving procedure

Satia

2016

Int J Reprod Contracept Obstet Gynecol

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Background:Although rare in modern obstetrics, emergency peripartum hysterectomy (EPH) remains a life-saving procedure, in the event of uncontrollable postpartum hemorrhage. Observations regarding the causes and outcomes of EPH provide valuable insights relevant to the current management perspectives in obstetrics. This study is intended to assess the contemporary prevalence, indications, and outcomes of EPH, at a Tertiary care referral institute. Methods: A descriptive observational study was conducted as a retrospective analysis of patient-records, over a span of 3 years January 2011-December 2013, in the department of obstetrics and gynecology, at the KEM hospital, in Mumbai. Cases of EPH were analyzed for information, maternal age, parity, gestational age, type of delivery, indications for EPH and outcomes of the procedure. Results: The average annual incidence rate was1 per 1000 deliveries. 44% of the cases had an indication of abnormal placentation. 60% of the cases had caesarean section deliveries. Multiparity, previous LSCS, and gestation period of <37 weeks, were the commonly observed associations. 52% of cases required ICU admission. Maternal mortality rate was 8%. 20% of the cases had intrauterine fetal death. Conclusions: Abnormal placentation was evident as the leading cause of uncontrollable hemorrhage. This is possibly in view of a continual improvement in the management of uterine atony, reduced incidence of uterine rupture, and importantly, a rising trend of caesarean section delivery. This calls for more thoughtful considerations, regarding decisions for caesarean section delivery, in obstetrics practice.

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Obstetric hysterectomy: an emergency lifesaving procedure

Satia

2016

Int J Reprod Contracept Obstet Gynecol

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“…7 Mukherjee et al in a retrospective study of obstetric hysterectomy in a tertiary care hospital reported no maternal mortality but high perinatal mortality (54.5%). 16 In present study, there were 6 maternal deaths in patients who underwent PH from 2007 to 2011, after that there were no death in PH cases inspite of their rising trend. It could be because of antenatal diagnosis of placenta accrete by colour Doppler and MRI and following a protocol for managing such cases with elective caesarean hysterectomy.…”

Section: 2mentioning

confidence: 91%

Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

Gupta

Deepika

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Peripartum hysterectomy is the most dramatic operation in modern obstetrics and is generally performed when all conservative measures fail to achieve haemostasis in the setting of life threatening haemorrhage. The objective was to review all peripartum hysterectomies performed at a tertiary care centre over a ten-year period from 2007 to 2016 to determine the incidence, types, indications and maternal outcome and also to study the changing trendsMethods: This was a retrospective, observational, analytical study of parturient women requiring peripartum hysterectomy (PH). We looked at data over a ten-year period, from January 2007 to December 2016. Case records were reviewed for socio-demographic characteristics of the patients, type and indications for the hysterectomy performed, booking status of patients, mode of delivery, gestational age at delivery and maternal outcome. Change in trends of the rate and indications of peripartum hysterectomy at the centre was also reviewed.Results: The overall rate of peripartum hysterectomy was 1/876 deliveries. The rate of peripartum hysterectomy had a 4-fold rise from 2007 to 2016.The primary indication was abnormal placentation which included morbidly adherent placentation 22/59 (37.2%) and placentapraevia 5/59 (8.4%), followed by intractable atonic haemorrhage in 35.6% of cases. Abnormal placentation as an indication for PH increased significantly form 34.6% (2007-2011) to 54.54% (2012-2016). After hysterectomy, 56% cases were admitted to ICU. All patients needed blood transfusion. Maternal mortality was 10.1%.Conclusions: Peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation.

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A retrospective study of obstetric hysterectomy in a tertiary care hospital

Cited by 2 publications

References 0 publications

Obstetric hysterectomy: an emergency lifesaving procedure

Obstetric hysterectomy: an emergency lifesaving procedure

Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

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