Publication:

Emergency obstetric hysterectomy in a tertiary referral centre: 10 years retrospective cross-sectional study

Background Emergency obstetric hysterectomy (OH) is the last resort opted to save life of a mother in critical obstetric conditions compromising her future reproductive potential but is a considered a lifesaving procedure in an emergency obstetric situation. We sought to study the socio-demographic factors, incidence, clinical risk factors, indications, complications and feto-maternal outcomes associated with emergency obstetric hysterectomy.

Methods This was a retrospective study. All cases of emergency hysterectomy were reviewed from various medical record section for a period of 10 years conducted at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Results There were 23 cases of emergency obstetric hysterectomy. The incidence of the study was 0.18%. 43.4% were grand-multiparous. Most common associated risk factor was previous caesarean section and grand-multiparous patient. The most common indication associated with OH was found to be postpartum hemorrhage. Majority (91%) of the patient received one or more blood product. The most common maternal outcome was need of ICU care. Maternal mortality was noted to be 8.7%.

Conclusions Adequate antenatal care, screening and counselling of high-risk pregnancies, avoidance of un-indicated caesarean section, counselling for family planning methods, anticipation and timely intervention are the key to prevent and reduce maternal/neonatal mortality and morbidity.