Critical analysis of peripartum hysterectomies at a tertiary level hospital in 1 year

ABSTRACT

Peripartum or obstetric hysterectomy is the removal of the corpus uteri alone or with the cervix at the time of a cesarean section, or shortly after a vaginal delivery. It is a challenging though life-saving obstetric procedure it is associated with morbidity and mortality. The medical records of 20 patients who had undergone peripartum hysterectomy, between April 2015 to April 2016 (1 year), in a tertiary teaching hospital, King George Hospital, Visakhapatnam, covering north coastal Andhra Pradesh and surrounding districts of Odisha were reviewed retrospectively. The results were analyzed. Emergency peripartum hysterectomy is a most demanding obstetric surgery performed in very trying circumstances of life threatening hemorrhage. The indication for emergency peripartum hysterectomy in recent years has changed from traditional uterine atony to abnormal placentation. Antenatal anticipation of the risk factors, involvement of an experienced obstetrician at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in reducing morbidity and mortality. Prompt performance of peripartum hysterectomy before patient clinical conditions deteriorate is the main key to success and less postoperative complications.