Emergency peripartum Hysterectomy: A Retrospective Study from a Teaching Hospital in Eastern India over Five Years
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 11
Abstract
Background: Emergency peripartum hysterectomy (EPH), although rare in modern obstetrics, remains a lifesaving procedure in cases of severe haemorrhage. Objective: To review the cases of emergency peripartum hysterectomy regarding their incidence, risk factors, indications, and complications and their results were carefully analyzed. Materials and Methods: A retrospective study of cases of emergency peripartum hysterectomy which were performed in the period between January 2013 and December 2016 at ICARE Institute of Medical Sciences, Haldia and Burdwan Medical College & Hospital in West Bengal was done. Clinical data extracted and closely interpreted. Results: In the study there were 40,093 deliveries and 81 cases of postpartum hysterectomies. The overall incidence was 0.097%. Caesarean hysterectomy was performed in 51 cases (0.373%) and postpartum hysterectomy was performed in 30 cases (0.113%). Total hysterectomy was performed in 23 cases (28.4%) and subtotal hysterectomy was performed in 58 cases (71.6%). The main indications for hysterectomy were uncontrolled postpartum haemorrhage (44.4%), ruptured uterus (33.3%) and morbidity adherent placenta (24.7%). There were 9 maternal deaths and 32 cases of stillbirths. Conclusion: Peripartum hysterectomy is a major life saving operation. Although PPH is the main indication, it is significantly associated with post caesarean cases. Obstetricians should identify patients at risk and anticipate the procedure and complications, as early interventions and proper management facilitate optimal outcome.
Authors and Affiliations
Amit Dutta
Keywords
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