EMERGENCY OBSTETRIC HYSTERECTOMY OVER A PERIOD OF SEVEN YEARS  A CLINICAL REVIEW

Dr C P Jishabai

Volume : VI, Issue : X, October - 2016

EMERGENCY OBSTETRIC HYSTERECTOMY OVER A PERIOD OF SEVEN YEARS A CLINICAL REVIEW

Dr C P Jishabai

Abstract :

This study is to determine the incidence, indications and maternal complications of emergency obstetric hysterectomies performed in a tertiary hospital over a period of seven years from January 2003 to December 2009. Maternal age, parity, indication for hysterectomy, type of the surgery performed, amount of blood transfused and complications were evaluated. During the study period there were 1,42,130 deliveries, out of which 40,399 (28.4%) were by cesarean section. Of the total deliveries, there were 197 emergency obstetric hysterectomies, with an incidence of 1.38 per 1000 deliveries. The commonest indication for emergency obstetric hysterectomy was atonic post partum hemorrhage followed by rupture uterus and abnormal placentation. Among the emergency obstetric hysterectomies, there were 24 (12.2%) cases of maternal death. Hypovolemic shock, disseminated intravascular coagulation and urinary bladder injury were the other complications. Facility for blood transfusion with early and timely referral of high risk cases to a tertiary centre can avoid emergency obstetric hysterectomies to a certain extent, thereby reducing maternal morbidity and mortality. Active management of third stage of labor should be practiced in all centers including peripheral hospitals for a better maternal outcome.