Emergency obstetric hysterectomy - one year review at Allied hospital, Faisalabad

ABSTRACT

To study the cases of obstetric hysterectomy performed over a period of one year [Jan. 2008 to Dec. 2008] in a teaching hospital to determine the incidence, indications, associated risk factor and maternal outcome of patients with a view to suggest ways of improving outcome. One year retrospective study of 38 consecutive cases of obstetric hysterectomies performed during the study period were analyzed. Total number of deliveries during the study period were 8988 and 38 emergency obstetric hysterectomies were undertaken; frequency being 0.42%. Only 26.3% women were booked. The most common indication for procedure were uterine rupture, uterine atony and morbidly adherent placenta. Total hysterectomies were undertaken in 73.6% and sub total in 26.3% women. There were 4 [10.5%] maternal deaths. Patients who died were received in critical condition and with massive haemorrhage. Late arrival and non availability of blood because of incooperative attendants were the main factor in maternal mortality. Emergency obstetric hysterectomy remains an essential life saving procedure. Proper antenatal care and early admission in labour ward, training and retraining of traditional birth, attendants, prompt resuscitation and referral of patient in time will go a long way to reduce the incidence of this procedure