A STUDY OF PERIPARTUM HYSTERECTOMY IN A TERTIARY REFERRAL CENTRE OVER A PERIOD OF 5 YEARS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 18
Abstract
BACKGROUND Peripartum hysterectomy in most cases is a lifesaving procedure, which is performed when other measures of controlling haemorrhage have failed, making it one of the markers for maternal morbidity and potential ‘near-miss’ mortality. MATERIALS AND METHODS A descriptive and retrospective analysis of 31 cases of obstetric hysterectomy was done at Bankura Sammilani Medical College and Hospital from January 2013 to December 2017. Case records were analysed to record the incidence, indications, risk factors and complications associated with peripartum hysterectomy during the study period. RESULTS Incidence of peripartum hysterectomy was 0.028%. The most common indication for peripartum hysterectomy was ruptured uterus with 22 cases (70.96%) followed by 7 cases of placental abnormalities (22.58%) and 2 cases of atonic postpartum haemorrhage (6.45%). Urinary tract infection (37.04%) was the most common associated complication and case fatality rate was 12.9%. CONCLUSION The primary cause of peripartum hysterectomy is ruptured uterus caused due to an increased rate of caesarean deliveries. This is resulting in subsequent pregnancies having complications due to an increased prevalence of trial of labour after caesarean (TOLAC). Peripartum hysterectomy can be delayed or prevented by various conservative medical and surgical techniques, but as it is a life-saving procedure, prompt decision should be made for performing a hysterectomy
Authors and Affiliations
Shibram Chattopadhyay, Siddhartha Majumder, Kajal Kumar Patra, Chandrakanto Mondal
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