• Bushra Khan
  • Baynazir Khan
  • Ruqqia Sultana
  • Rubina Bashir
  • Farhat Deeba


Background: Emergency peripartum hysterectomy (EPH) is a life saving procedure considered incases of severe haemorrhage unresponsive to medical and conservative surgical procedures. The aimof present study was to review the frequency, indications, maternal morbidity and mortalityassociated with emergency peripartum hysterectomy in a tertiary care hospital in a developingcountry. Methods: This was a cross sectional study in which data was retrospectively collected fromJanuary 2000 to December 2010. Main outcome measures were maternal morbidity and mortalityassociated with EPH. Results: The incidence of EPH was 10.52/1000 deliveries. The main causes ofEPH were rupture uterus 76 (34.86%), atonic uterus 65 (29.81%), placenta accreta 19 (8.71%),placenta previa 17 (7.7%), and placental abruption 36 (16.5%). Mostly subtotal hysterectomy wasthe preferred method done in 196 (89.9%) of cases, while total abdominal hysterectomy was doneonly in 22 (10.09%) of cases. The over all complication rate was 81.2% which included both minorand major complications like hypovolemic shock 180 (82.5%), febrile morbidity 108 (49.5%),wound infection 40 (18.3%), bladder injury 6 (2.75%), and thrombophlebitis 22 (10.09%). Thematernal mortality in present review was (10.5%). Conclusion: Frequency of EPH was found to behigh in this study. Obstetricians must be skilled in it particularly in developing countries where themain indication of hysterectomy is rupture uterus.Keywords: Emergency peri-partum hysterectomy, maternal morbidity, maternal mortality


Katz VL, Cefalo RC. History and evolution of caesarean

delivery. In: Phelan JP, Clark SL, (Eds). Caesarean delivery.

New York: Elsevier;1988.p. 9–10.

Rogers MS, Chang AMZ. Post partum hemorrhage and other

problems of third stage. In: James DK, Steer PJ, Weiner CP,

Gonik B, (Eds). High Risk Pregnancy-Management Options, 3rd

edition. Philadelphia: W B Saunders;2006.p.1559–78.

Chestnut DH, Eden RD, Gall SA, Parker RT. Peripartum

hysterectomy: A review of cesarean and postpartum

hyeterectomy. Obstet Gynecol 1985;65:365–70.

Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH. Emergency

hysterectomy for obstetric hemorrhage. Obstet Gynecol


Stanco LM, Schrimmer DB, Paul RH, Mishell DR. Emergency

peripartum hysterectomy and associated risk factors. Am J Obstet

Gynecol 1993;168:879–83.

Zelop CM, Harlow BL, Ferigoletto FD, Safon LE, Saltzman DH,

Emergency peripartum hysterectomy. Am J Obstet Gynecol


Abouzahr C. Antepartum and Postpartum Hemorrhage. In:

Murray CJ, Lopez AD, (Eds). Health Dimensions of Sex and

Reproduction. Boston, Mass: Harvard University Press; 1998.p.


Fikree FF, Midhet F, Sadruddin S, Berendes HW, Maternal

Mortality in different Pakistani sites: ratios, clinical causes and

determinants. Acta Obstet Gynecol Scand 1997;76:637–45.

Begum S, Nisa A, Begum I. Analysis of Maternal Mortality in a

Tertiary Care Hospital to determine causes and preventable

factors. J Ayub Med Coll Abbottabad 2003;15(2):49–52.

Khanum Z, Lodhi SK, Emergency Obstetric Hysterectomy: a life

saving procedure. Ann King Edward Med Coll 2004;10:292–4.

Mahmood S, Ayaz A, Obsterrical hysterectomy. J Surg Pak


Knight M. Peripertum hysterectomy in the UK: Management and

Outcomes of the Associated Hemorrhage. BJOG


Udoma E, John M, Etuk S, Ekanem A. Mortality in Calabar,

Nigeria. Nig J Med Prac 2003;66:52–5.

Sturdee DW, Rushton DL. Cesarean and post partum

hysterectomy. Br J Obstet Gynecol 1986;93:270–4.

Sinah H, Mishra M. Hysterectomy for Obstetric emergency. J

Obstet Gynecol India 2001;51:111–4.

Praneshwari Devi RK, Singh N, Singh D. Emergency

hysterectomy: A study of 26 cases over a period of 5 years. J

Obstet Gynecol 2004;54:343–5.

Anita K, Kavita W. Emergency obstetric hysterectomy. J Obstet

Gynecol India 2005;55:132–4.

Yalinkaya A, Guzel AI, Kangal K. Emergency Peripartum

Hysterectomy: 16-year Experience of a Medical Hospital. J Chin

Med Assoc 2010;73:360–3.

Najam R, Bansal P, Sharma R, Agarwal D. Emergency Obstetric

hysterectomy: A Retrospective study at a Tertiary care hospital. J

Clin Diag Res 2010;4:2864–8.

Nisar N, Sohoo NA. Emergency Peripartum Hysterectomy:

Frequency, Indications and Maternal Outcome. J Ayub Med Coll

Abbottabad 2009;21:48–51.

Begum I, Khan A, Khan S, Begum S. Caesarean and post partum

hysterectomy. Pak J Med Res 2004;43:134–7.

Noor S, Majid S, Ruby N. An Audit of Obstetrical Hysterectomy.

J Coll Physcians Surg Pak 2001;11:642–5.

Sahu L, Chakravertty B, Panda S, Hysterectomy for obstetric

emergencies. J Obstet Gynecol India 2004;54:34–6.

Mukherjee P, Mukherjee G, Das C. Obstetric hysterectomy. A

review of 107 cases. J Obstet Gynecol India 2002;52:34–6.

Cieminski A, Dlugoliecki F, Placenta previa accreta. Ginekol Pol


Choi SJ, Song SE, Jung KL, Oh SY, Kim JH, Roh CR.

Antepartum risk factors associated with peripartum cesarean

hysterectomy in women with placenta previa. Am J Perinatal


Radha T, Prabhu B, Radha G. J Obstet Gynecol India


Afaf RA, Alsayali, Salah, Baloul. Emergency obstetric

Hysterectomy: 8-Year Review at Taif Maternity Hospital, Saudi

Arabia. Ann Saudi Med 2000;20:454–6.

Mantri L, Maheshwari K, Chandra. Emergency hysterectomy–A

ten years review. J Obstet Gynecol India 1995;43:936–9.

Allahabadia G, Vaidya P. Obstetric hysterectomy (A review of

cases from January 1987 to August 1990). J Obstet Gynecol

India 1991;41:634–7.



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