Emergency obstetric hysterectomy: A clinical study

Abstract

Emergency obstetric hysterectomy is a life saving procedure. Its incidence is on the rise as is the increasing incidence of caesarean sections and placenta accrete spectrum. Methods: This descriptive prospective study was conducted for a period of two years on patients who underwent emergency obstetric hysterectomy to determine the frequency, demographic characters, indications and fetomaternal outcomes from July 17 to June 19 at tertiary care institute of Punjab in Department of Obstetrics and Gynaecology, GMC Patiala. Results: There were 40 cases of obstetric hysterectomy out of 10859 deliveries giving an incidence of 3.6 per 1000 births, Most of the patients were unbooked (87.5%). 65% were multiparas. Maximum number of women (50%) were in age group 26 to 30 years. 75% patients were cases of previous caesarean. 80% among these had placenta accrete spectrum and these ended up in caesarean hysterectomy. There were five maternal deaths attributed to late referral, irreversible haemorrhagic shock and acute respiratory distress syndrome. Maternal death to maternal near miss ratio during study period was 1:6.4. Conclusion:Emergency obstetric hysterectomy is definitely life saving procedure but we should reduce its iatrogenic incidence by reducing the incidence of scarred uterus.