EMERGENCY OBSTETRIC HYSTERECTOMY- A STUDY IN TERTIARY CARE CENTRE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 90
Abstract
BACKGROUND Emergency obstetric hysterectomy (EOH) refers to surgical removal of a pregnant uterus or recently pregnant uterus. Many a times, an attempt to control haemorrhage fails and woman’s life is saved by compromising her reproductive capability by obstetric hysterectomy. It is usually performed in the face of unrelenting and life-threatening obstetric haemorrhage. We sought to study cases of obstetric hysterectomy over a period of one year to determine the incidence, indications, maternal complications and use of vasopressor drugs in a teaching institute. MATERIALS AND METHODS We conducted a Retrospective Observational Study over a period of one year from August 2016 to August 2017. A total of five cases of emergency obstetric hysterectomy (EOH) were studied in the Department of Obstetrics and Gynaecology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh. RESULTS The incidence of EOH in our study was 02 per 1500 following vaginal delivery and 02 per 500 following caesarean section. The overall incidence was 05 per 2000 deliveries. Atonic postpartum haemorrhage (60%) was the most common indication followed by placenta accreta (20%) and uterine rupture (20%). The most frequent sequelae were ICU admissions (45%) and fever (27%), while vasopressors were given in 18% of the total patients studied. There was no maternal death in the study. CONCLUSION A balanced approach to EOH can prove to be life-saving at times when conservative surgical modalities fail and interventional radiology is not immediately available. Our study highlights the place of extirpative surgery in modern obstetrics in the face of rising rates of caesarean section and multiple pregnancies, particularly in urban settings in developing countries.
Authors and Affiliations
Eshu Dixit, Shruti Pathak, Nootan Chandwaskar, Natu N
Keywords
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- EP ID EP278229
- DOI 10.14260/jemds/2017/1366
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