Peripartum Hysterectomy and Analysis of Risk Factors

Basnet, Pritha; Rai, Rubina; Agrawal, Ajay; Thakur, Achala; Shrestha, Ramesh

doi:10.3126/njog.v12i1.18981

Cited by 3 publications

(5 citation statements)

References 12 publications

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“…A similar study showed an incidence of 1.48 per thousand which was higher than our study. 11 Our study showed the main indication of EPH was placenta accreta spectrum 62.5% followed by uterine atony 32.5% but another study showed rupture uterus was the common indication. 11 Several studies have shown that abnormal placentation is the major cause of EPH, replacing uterine atony.…”

Section: Discussionmentioning

confidence: 49%

“…Another study showed three mortality due to haemorrhagic shock. 11 In another study showed there was no mortality death report. 14 …”

Section: Discussionmentioning

confidence: 96%

“…Another study showed three mortality due to haemorrhagic shock. 11 In another study showed there was no mortality death report. 14 Incidence of urinary tract injury in studies from the UK, 13 China, 9 and another centre from India 10 were 12.2%, 4.1%, and 7.93% respectively.…”

Section: Discussionmentioning

confidence: 96%

“…Our study showed the main indication of EPH was placenta accreta spectrum 62.5% followed by uterine atony 32.5% but another study showed rupture uterus was the common indication. 11 Several studies have shown that abnormal placentation is the major cause of EPH, replacing uterine atony. 4 , 5 This is due to the successful management of uterine atony with uterotonics, embolization, B-lynch suture, condom tamponade and selective devascularisation.…”

Section: Discussionmentioning

confidence: 99%

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Peripartum Hysterectomy among Patients Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

et al. 2023

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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.

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Section: Discussionmentioning

confidence: 49%

“…Another study showed three mortality due to haemorrhagic shock. 11 In another study showed there was no mortality death report. 14 …”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Peripartum Hysterectomy among Patients Admitted to the Department of Obstetrics and Gynaecology in a Tertiary Care Centre: A Descriptive Cross-sectional Study

et al. 2023

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“…The main reason being unbooked cases, obstructed labour and previous cesarean section. 20,21 Whereas in some center, in Nepal and Egypt the primary indication is uterine atony. 11,22 EPH is a massive challenge to the obstetrician and anesthesiologist.…”

Section: Discussionmentioning

confidence: 99%

Peripartum hysterectomy at a tertiary center

Gurung

Baral

2021

Nepal J Obstet Gynaecol

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Aims: To find out the incidence, indications, complication of emergency peripartum hysterectomy in a tertiary care center. Methods: This was a retrospective study conducted over a period of 18 months from April 2017 to October 2018 at Paropakar Maternity and Women’s Hospital in Kathmandu. Data were obtained from the operation theater register and record section. Results: Out of 30917 deliveries in 18 months 18 had lifesaving emergency peripartum hysterectomy (0.58 per 1000 deliveries). The most common indication being morbidly adherent placenta/placenta previa (8; 44%) followed by ruptured uterus (5; 28%), uterine atony (4; 22%). The most common risk factor is attributed to previous cesarean section (11; 61%) followed by abnormal placentation (7; 39%). Most common morbidity was febrile morbidity followed by wound infection and bladder injury. Conclusion: Abnormal placentation and past cesarean section contributed to be the major indication of peripartum hysterectomy.

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