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 studywas carried out to evaluate in our setup the frequency of obstetric hysterectomy, its indication, riskfactors, complication, morbidity, mortality and avoidable factors. Methods: A descriptive study ofall patients who under went obstetric hysterectomy was conducted from 1st May, 2004 to 31stOctober, 2005 at Gynaecology and Obstetric Unit-II, III of Liaquat University of Medical andHealth Science Hospital, Hyderabad. After collecting the data on pre-designed proforma the datawas 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 wastaken as p<0.05. Results: During the study time period there were total 6495 deliveries and 41cases of obstetric hysterectomy were identified, giving a frequency of 0.63% or 1 in 158deliveries. 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 healthcareproviders (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 necessitatinghysterectomy. Conclusion: Incidence of obstetric hysterectomy in our woman is very high. Thereason being many avoidable factors such as high parity, inadequate maternity and familyplanning services, lack of proper referral system, un-booked status, mismanaged labour, illiteracyon the part of woman herself, family and health care providers are not taken care of duringpregnancy, labour and puerperium.Keywords: Obstetric hysterectomy, multiparity, Injudicious use of oxytocics, uterine rupture,maternal morbidity and mortalityReferences
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