Indication and maternal outcome of emergency peripartum hysterectomy

ABSTRACT

To analyze the maternal outcome of peripartum hysterectomy in badly handled cases with ruptured uterus and severe post partum haemorrhage. A retrospective study carried out in Obstetric and Gynaecology Unit-II, Divisional Headquarter Hospital [D. H. Q.] Faisalabad over a period of two years. Thirty patients who underwent emergency peripartum hysterectomy during the study period of two years. Indications, associated maternal morbidity and mortality of peripartum hysterectomy. There were 30 cases of emergency peripartum hysterectomy over a period of two years. The most common indication was uterine rupture [42.9%], followed by uterine atony [26.6%]. All women required blood transfusion, five [17%] developed coogulopathy, four [13.3%] had bladder injuries, two [6%] required salpingoophorectomy for uncontrolled adnexal bleeding and two [6%] patients underwent a repeat laparotomy for internal haemorrhage. Maternal mortality was 6% [n=2]. Peripartum hysterectomy continues to have a high incidence in our community. High parity, illiteracy and ignorance coupled with inadequate maternity services, injudicious use of syntocinon, improper third stage management, abnormal placentation and uterine atony were identified as risk factors for emergency peripartum hysterectomy. An early decision of obstetrician can save blood loss and prevent complications