EMERGENCY OBSTETRIC HYSTERECTOMY

Background: Emergency hysterectomy in obstetric practice is generallyperformed in the setting of life-threatening hemorrhage which fails to be controlled byconservative management. Objective: To review 8 years’ experience of emergency obstetrichysterectomy in a teaching hospital. Study Design: A retrospective descriptive study based onhospital data of 156 patients undergoing emergency Obstetric hysterectomy. Settings: Obs. &Gynae. Department Unit-I, PMC Allied Hospital Faisalabad. Methods: This was a retrospectivereview carried out from March 2004 to Feb 2012 Main outcome measures were frequency,indications, associated risk factors and maternal morbidity and mortality associated withemergency peripartum/obstetric hysterectomy. Results: During 8 years there were total 156(0.38%, 3.8 per 1000) emergency obstetric hysterectomies out of which there were 46 caesarianhysterectomies, 65 post partum, 45 for ruptured uterus with total number of delivery 40062.Number of hysterectomies was 48 in the first 4 years of the study (March 2004- Feb 2008) andduring the last 4 years (March 2008- Feb 2012) it was 108. Maximum obstetric hysterectomieswere in para 3-5 (53.20%) and in 26-30 years age group (35.89%). The most common indicationfor hysterectomy was uterine atony (44.23%) followed by uterine rupture (28.85%), Placentaaccreta (14.745%) and placenta previa (11.53%). The maternal mortality was 6.41% (10patients). In this series 80% patients were referred from other areas. Conclusions: Frequencyof emergency Obstetric hysterectomy is high in our tertiary center and it is continuouslyincreasing due to increased referral of patients. The mortality and morbidity of performingobstetric hysterectomy is higher in patients referred from outside hospital.