A TEN YEAR REVIEW OF EMERGENCY PERIPARTUM HYSTERECTOMY IN A TERTIARY CARE HOSPITAL
AbstractBackground: 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
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