Emergency obstretrical hysterectomy [EOH]: a life saving procedure in obstetrics

ABSTRACT

To assess the frequency, causes and sequelage of Obstetrical Hysterectomies in a tertiary care unit. Prospective, observational study from 1st Jan. 2001 to 28th Feb. 2006. Departmetn of Gynaecology and Obstetrics, Unit III, Civil Hopsital, Karachi. All Obstetrical Hysterctomies doen during the study period. Out of 11,032 obstetrical patients admitted during the study period, 62 underwent EOH. Their biodata, clinical features, investigations, blood transfusions, operative procedures, morbidity, mortality and follow-up was recorded on a profoma. The data thus obtained was compiled and analyzed. The frequency of EOH was 5.6/1000 obstetric cases. Majority [85.5%] of the cases were referred from elsewhere, while only 9 [14.5%] cases were booked. Multipara and grand multipara [94%] cases were mostly involved and the commonest cause was ruptured uterus [34%]. The maternal mortality was 9.7%. Proper antenatal care, early referral, liberal blood transfusion, timely decision and surgery by an experienced obstetrician are milestones on the road to justify EOH