Assessment of prevalence, indications, outcomes and post operative complications of obstetric hysterectomy: at Mettu karel comprehensive specialized hospital, Mettu, south weast, Ethiopia

Abstract Background: Obstetric hysterectomy is indicated when patient's life is at risk, related to significant maternal mortality and morbidity and it is also a potentially lifesaving procedure. In developed countries, the reported incidence of emergency hysterectomy is below 0.1% of the total normal deliveries performed, while in developing countries, the incidence rates are as high as 1-5/ 1000 of all the deliveries performed. Objective: The aim of the study was to estimate incidence, indications, risk factors and operative morbidity and mortality in pregnant women undergoing obstetric hysterectomy (OH) in seven years at Mettu Karle comprehensive specializedHospital: from April 2018 to April 2025 GC. Methods and Materials: A facility based retrospective cross sectional review of obstetric records was obtained over a period of seven years (April 2018 to April 2025 GC). Study was conducted from October 2018 to June 2025 GC. All women treated at Mettu Karle comprehensive specialized Hospital for the indication of obstetrics hysterectomy were included in the study. Data was collected with structured format. Results were analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0. For all statistical significance tests the cut off value set is P<0.05 and binary logistic regressions will use to estimate the crude odds ratios of maternal outcome. Result-There were a total of 8657 confinements and 65cases of OH was undertaken during the study period to give an incidence of 6.6/1000 deliveries with a maximum numbers of patients (n=20, 27.4 %) in the age group of >35yrs and parity of 3-4 (46.5%). Ruptured uterus (n=55, 75.3%), atonic PPH (n=6, 8.2%).), post partal sepsis and perforated uterus secondary to unsafe abortion (n=4, 5.5%) were the commonest causes for this life saving surgery. Out of the 65 hysterectomies performed, 56 (76.7%) were total hysterectomy and 17(23.3%) were subtotal hysterectomy. There were six maternal deaths (9.2%).Duration of hospital stay >4 hrs before operation (OR=7.5, CI=2.64-21.28) were statistically associated with maternal death. Conclusion and Recommendation: The incidence of OH and maternal death in Mettu Karle comprehensive specializedHospital was high. Good maternal care, ANC follow up, active management of labor, early recognition of complications and timely referral will go a long way in ensuring for a better outcome.