Abstract

OBSTETRIC HYSTERECTOMY- EMERGENCY SITUATION

Author(s): Rajni Priyanka, Chitra Sinha

BACKGROUND Hysterectomy can be performed for obstetric complications at any period of gestation to save the life of patient. It is performed after vaginal delivery, or during caesarean section for antepartum haemorrhage, postpartum haemorrhage, or rupture uterus, or due to morbidly adherent placenta. We wanted to study the incidence of obstetric hysterectomy, its indications, the demographic profile, and postoperative maternal complications in patient attending the labour room emergency of Patna Medical College Hospital, Patna. METHODS Patients in this study group were selected from Emergency Obstetric Unit of Patna Medical College & Hospital, Patna, who had undergone hysterectomy for obstetric indications like APH, PPH and rupture uterus. Patients who underwent hysterectomy for some early pregnancy complications such as pregnancy termination followed by perforation and sepsis & some rare cases like rupture cornual pregnancy or perforating hydatidiform mole were also included in this study. This is an observational study conducted from January 2017 December 2018. RESULTS During the study period, there were 14,895 deliveries, out of which 96 cases underwent EOH giving an incidence of 0.6%. The main causes of EOH were morbidly adherent placenta (43.7%), rupture uterus (33.3%), atonic PPH (15.6%) & early pregnancy complications (7.2%). CONCLUSIONS There is marked increase in the incidence of placenta accreta and rupture uterus leading to obstetric hysterectomy.