[30 years' experience of obstetric hysterectomy]

Sixty-eight cases of obstetric hysterectomy were performed in our hospital from 1960 to 1989, an incidence of 27.63/10,000. The maternal mortality was 8.82% (6/68). Forty-four hysterectomies were done at end of cesarean sections and twenty-four performed after vaginal deliveries. Uterine rupture (48.53%) was the chief indication for emergent hysterectomies and placental disorders came next in frequency. The most common indication for nonemergency hysterectomies was uterine leiomyoma. The emergence of placenta accreta as major indication for hysterectomy is an obvious change since the past decade. Twelve of these patients (17.65%) underwent total abdominal hysterectomy and fifty-six (82.35%) subtotal hysterectomy. The operative indications, conditions and problems are discussed.