MORBIDITY AND MORTALITY ASSOCIATED WITH OBSTETRIC HYSTERECTOMY
Abstract
Background: Obstetric hysterectomy still complicates a substantial number of pregnancies inthird world countries and is a significant cause of obstetric morbidity and mortality. This study
was carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, risk
factors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study of
all patients who under went obstetric hysterectomy was conducted from 1st May, 2004 to 31st
October, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical and
Health Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the data
was fed to SPSS in the form of frequency distribution tables and percentages were calculated.
Statistical analysis of data was performed by using Chi-square test. The level of significance was
taken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41
cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158
deliveries. Most of patients were from rural areas (82.92%), un-booked 73.17%), uneducated
(95%), lower socioeconomical class (92.69%), 25-29 years age (48.78%) multiparae (56.10%),
have to travel a distance of <100 km to reach hospital and referred late (51%) by healthcare
providers (doctors). Majority of hysterectomies were performed due to ruptured uteri (51.21%).
There were 5 maternal and 26 perinatal deaths; all were due to severity of conditions necessitating
hysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. The
reason being many avoidable factors such as high parity, inadequate maternity and family
planning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracy
on the part of woman herself, family and health care providers are not taken care of during
pregnancy, labour and puerperium.
Keywords: Obstetric hysterectomy, multiparity, Injudicious use of oxytocics, uterine rupture,
maternal morbidity and mortality
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