Emergency Obstetric Hysterectomy

Abstract

Objective: To evaluate the frequency of emergency obstetric hysterectomy, and to find out its indications and accompanying maternal and perinatal morbidity and mortality. Methodology: This cross sectional study was undertaken at Obstetrics and Gynaecology department of Unit-I, Jinnah Postgraduate Medical Centre, Karachi from 1st January 2015 to 31st December 2016. Those patients who had emergency obstetric hysterectomy at JPMC during this period were included in the study. Their parity, booking status, age, indication and, the type of surgery undertaken was recorded. Maternal and fetal morbidity and mortality were also determined. Data was analyzed using SPSS 20. Results: A total of 14,157 deliveries were carried out during the study period. Out of them, 32 hysterectomies were undertaken due to obstetric indications (0.22%). The most common indication was ruptured uterus in 20 (62.5%). The most common complication was infection (40.6%). Five patients could not survive after the surgery (15.6%) and perinatal deaths were 19 (59.3%). Conclusion: Obstetric hysterectomy needs to be done in emergency cases where life of the patient can not be saved otherwise. However, clear judgement, highly professional surgical technique and optimal time for the surgery can decrease mortality and morbidity in such cases.