Em Ergency Peripartum Hysterectomy: A Five Year Study

Abstract

Emergency peripartum hysterectomy is performed as a life saving measure in uncontrolled PPH. OBJECTIVES: To examine incidence, risk factors, indications, outcome and complications of emergency peripartum hysterectomy in a teaching hospital. METHODS: A 5 year prospective study conducted between January 2010 to December 2014. Demographic data, detailed history, clinical examination and relevant investigations obtained. RESULTS: The incidence of EPH in present study was 0.6 per 1000 deliveries. Most of these patients were young, mean age of 22.67 years, para 1 and 2, 84.21% were unbooked with no antenatal visits and delivered outside. Rupture of uterus was the commonest indication (42.10%) for EPH, followed by uterine atony (26.32%) and abnormal placentation (26.32%). Both total or subtotal hysterectomy were performed as a life saving measure after conservative measures failed. Maternal mortality in this study was 15.79%. Other complications noted were febrile illness, anaemia, coagulopathy, renal failure, wound infection. CONCLUSION: EPH performed for uncontrolled PPH is associated with significant mortality and morbidity. Its incidence can be reduced by regular antenatal check-ups, early detection and referral of high risk patients and updating knowledge and skill of doctors working in peripheral centres.