Analysis of Obstetric Hysterectomy done over a period of 7 years in a Tertiary Care Centre

Preeti Lewis; Aditi Abhade; Rangan Bhattacharya

Volume : VIII, Issue : IV, April - 2019

Analysis of Obstetric Hysterectomy done over a period of 7 years in a Tertiary Care Centre

Preeti Lewis, Aditi Abhade, Rangan Bhattacharya

Abstract :

Background: Although rare in modern obstetrics, emergency obstetric hysterectomy (OH) remains a life–saving procedure, in the event of uncontrollable postpartum haemorrhage. Observations regarding the indications and outcomes of OH provide valuable insights relevant to the current management perspectives in obstetrics. This study intends to assess the incidence, indications, and outcomes of OH, at a Tertiary care referral institute. Methods: An observational analytical study was conducted as a retrospective analysis over a span of 7 years June 2011–June 2018, in the department of obstetrics and gynecology, at a tertiary care centre. Cases of OH were analyzed for incidence, gestational age, parity, mode of delivery, indications for OH and outcomes of the procedure. Results: The incidence rate was 1 per 1000 deliveries. Atonic post partum haemorrhage(PPH) was the most common indication 37.1% . 31.4% of the cases had an indication of abnormal placentation. 57.14% of the cases had caesarean section deliveries. 57.1% required ICU admissions and maternal mortality rate was 8.6%. Foetal outcome was satisfactory in 57.1% and 25.7 % were stillbirths. Conclusion: Atonic PPH followed by Abnormal placentation were evident as the leading causes of uncontrollable haemorrhage. This is possibly in view of a continual improvement in the management of uterine atony, reduced incidence of uterine rupture, and importantly, a rising trend of caesarean section delivery. This calls for more thoughtful approach, regarding decisions for caesarean section delivery in obstetrics practice.