Introduction: Increase in the incidence of Emergency Peripartum Hysterectomy (EPH) is attributed to the increasing rate of cesarean delivery and its associated complications in subsequent pregnancy. In spite of availability of newer uterotonic drugs and other modalities for prevention and control, atonic PPH remains an important indication for EPH.

Objectives: To determine the incidence, risk factors, indications, outcome and complications of EPH.

Methods: A retrospective study of 26 cases of EPH performed over a period of one year from October 2015 to September 2016 at Civil Hospital, Ahmedabad, Gujarat, India.

Result: There were 26 cases of EPH out of 7844 deliveries showing the incidence of 3.3 per 1000 deliveries, 1.1 per 1000 vaginal deliveries and 8.6 per 1000 CS. Uterine rupture was the most common cause of EPH (34.6%) followed by atonic PPH (30.7%) and morbidly adherent placenta (27%). 77% patients had history of previous one or more cesarean sections. There were 15.4% maternal deaths and 58% babies were still birth due to uterine rupture, placenta previa or prematurity. 27% patients developed postoperative fever.

Conclusion: Primary cesarean section should be avoided as far as possible. Regular antenatal care and timely decision for an elective cesarean section are very important factors in patients with recurrent indications of cesarean to prevent uterine rupture. Patients with placenta previa or adherent placenta should be referred timely to higher center. Decision to perform EPH should be taken timely.