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Indian Journal of Obstetrics and Gynecology

Volume  8, Issue 1, January-March 2020, Pages 25-30
 

Original Article

Emergency Peripartum Hysterectomy—Incidence, Indications, Fetomaternal Complications: A Retrospective Observational Study From A Tertiary Care Teaching Hospital

Bunty Dinani1, Seema Pundir2

1Senior Resident 2Specialist, Department of Obstetrics and Gynaecology, Baba Saheb Ambedkar Hospital, Rohini, New Delhi, Delhi 110085, India.

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DOI: http://dx.doi.org/10.21088/ijog.2321.1636.8120.4

Abstract

Introduction: To determine the incidence, indications, risk factors and fetomaternal complications associated with emergency peripartum hysterectomy. Material and method: This is a retrospective case series where hospital file record of patients who underwent EPH during January 2016 to December 2018 in the department of obstetrics and gynecology, BSAH, New Delhi after ethical approval were thoroughly examined. Data regarding incidence, indications, risk factors and fetomaternal complications of EPH were obtained. Results: During the study period, there were total of 39 emergency peripartum hysterectomies, with the incidence of 1.6 per 1000 deliveries. The various indications for hysterectomy were uterine atony (33%) followed by placenta previa (18%), adherent placenta (18%) and uterine rupture (10%). The risk factors associated were multiparity (74%), previous cesarean section (25%) and obstructed labor (20%). Common postoperative complications were fever, wound infection and DIC. The maternal mortality rate was 13% and perinatal mortality rate was 23%. Conclusion: Emergency peripartum hysterectomy is a potentially lifesaving procedure associated with significant maternal morbidity and mortality. Uterine atony and abnormal placenta were the common indication for emergency peripartum hysterectomy. Previous scar, multiparity and abnormal placentation were the significant risk factors.


Keywords : Peripartum hysterectomy; Maternal morbidity and mortality; Fetomaternal complications.
Corresponding Author : Bunty Dinani