Peripartum Hysterectomy -Incidence, Indications, Risk Factors and Outcomes at a Teritiary Care Hospital

Abstract

Introduction: Peripartum hysterectomy is defined as a hysterectomy performed at the time, or within 24 hours, of delivery. It is a life saving procedure and becomes necessary when all medical and surgical methods fail to control bleeding. It is associated with significant maternal morbidity and mortality. Objectives: To determine the incidence, indications, maternal and perinatal outcome of peripartum hysterectomy Methods: A retrospective hospital based observational study of all women who underwent peripartum hysterectomy over a period of 2 years from January 2020 to December 2021 in the department of Obstetrics and Gynaecology, SIDDARTHA MEDICAL COLLEGE, VIJAYAWADA. Results: A total of 20 peripartum hysterectomies were done during the study period. Incidence was 1.08/1000 deliveries. Main indications of peripartum hysterectomy were uterine atony (45%), abnormal placentation (30%), and uterine rupture (10%). Total abdominal hysterectomy was done in 15% cases and subtotal hysterectomies were done in 85% cases. There was one maternal death (5%) and 5 perinatal deaths (25%). Conclusion: Atonic uterus is the commonest indication for peripartum hysterectomy. Previous scar, multiparity and abnormal placentation were the significant risk factors.