Morbidity and mortality associated with obstetric hysterectomy

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Surgical Outcomes

Background:

• Obstetric hysterectomy remains a significant contributor to maternal morbidity and mortality in third-world countries.
• This procedure complicates a substantial number of pregnancies, necessitating evaluation of its local impact.

Purpose of the Study:

• To assess the frequency, indications, risk factors, and outcomes of obstetric hysterectomy.
• To identify avoidable factors contributing to this surgical complication in a specific healthcare setting.

Main Methods:

• A descriptive study was conducted over 13 months, analyzing 41 cases of obstetric hysterectomy.
• Data collected via a pre-designed proforma were analyzed using SPSS, with statistical significance set at p<0.05.

Main Results:

• The frequency of obstetric hysterectomy was 0.63% (1 in 158 deliveries), with most patients being unbooked, uneducated, and from lower socioeconomic classes.
• Ruptured uteri were the primary indication (51.21%), leading to 5 maternal and 26 perinatal deaths.
• Risk factors included late referrals, high parity, and rural origin.

Conclusions:

• The incidence of obstetric hysterectomy is high, driven by numerous avoidable factors.
• Inadequate maternity services, poor referral systems, illiteracy, and mismanaged labor contribute significantly.
• Improving maternal healthcare and family planning services is essential to reduce this complication.