Peripartum hysterectomy and its risk factors

Renuka Tamrakar; Upendra Pandit; Sabita Shrestha; Basant Sharma; Rakshya Joshi

Renuka Tamrakar Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
Upendra Pandit Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
Sabita Shrestha Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
Basant Sharma Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
Rakshya Joshi Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Abstract

DOI: https://doi.org/10.3126/jcmc.v9i1.23779

Background: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving surgical procedure considered in cases of severe hemorrhage unresponsive to medical and conservative management. The objective is to review incidence, identification, intervention and impact of emergency peripartum hysterectomy.

Methods: The retrospective, cross-sectional study designed was to used. EPH data were collected from January 2014 to December 2018.Descriptive statistics was used to analyzed data and presented in tables and charts.

Results: Incidence of Emergency Peripartum Hysterectomies was 2.3% out of 252(2.6%) cases of obstetrical emergencies and 0.06% that is 1 in 1600 deliveries. Most common indications for EPH were uterine rupture (33.3%); placenta accreta (33.3%) followed by retained placenta (16.6%) and endometritis with pyometritis (16.6%). Estimated blood loss 1916 ml., timeliness from delivery to hysterectomy was 140 minutes; most common post-operative complication was surgical site infection (33.3%) and length of hospital stay 11.7 days. Maternal morbidity rate was 33.3%. There was no maternal mortality recorded.

Conclusions: The timely intervention improves the outcome in Peripartum Hysterectomy, which is frequently associated with abnormal placentation as a consequence of increasing caesarean deliveries rate.

Keywords: Cesarean hysterectomy, Peripartum hyterectomy, Postpartum hysterectomy