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Obstetric hysterectomy: a life saving emergency
1Department of Obstetrics and Gynaecology, Mahila Chikitsalaya, S.M.S. Medical College, Jaipur, Rajasthan, India.
Objective:
To study the cases of obstetric hysterectomy performed over a period of 1 year (January 2008 to December 2008) in tertiary care center to estimate the incidence, indications, and maternal outcome following the procedure.
Materials And Methods:
A retrospective analysis of 20 cases of emergency obstetric hysterectomies performed during the study period.
Results:
During the study period, there were 11,356 deliveries and 20 emergency hysterectomies were done, giving an incidence of 0.17%. 75% cases were unbooked. Ruptured uterus was the most common indication for the procedure, followed by atonic Post-partum haemorrhage (PPH). Six out of 10 cases of rupture uterus had a previous cesarean delivery. Maternal mortality was 15% due to late referral.
Conclusion:
Emergency obstetric hysterectomy though a rare operation, still remains a life-saving procedure with which every obstetrician must be conversant. Regular antenatal care, identification of high-risk cases, and prompt referral can reduce the incidence of this operation.
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