EMERGENCY OBSTETRIC HYSTERECTOMY: A RETROSPECTIVE STUDY IN BBMCH BALANGIR, OVER ONE YEAR

Background:Emergency obstetric hysterectomy (EOH), although rare in modern obstetrics, remains a life-saving procedure in cases of severe hemorrhage. Purpose:To determine the incidence, risk factors, indications, outcomes, and complications of EOH performed in a tertiary teaching hospital and to compare the results with other reports in the literature. Methods:The medical records of 19 patients who had undergone EOH, between November 2017 and October 2018, were reviewed retrospectively. Maternal characteristics and characteristics of the present pregnancy and delivery, hysterectomy indications, operative complications, postoperative conditions, and maternal and neonatal outcomes were evaluated. Results. There were 19 EOHs out of 9738 deliveries, a rate of 1.9 per 1,000 deliveries. Eighteen hysterectomies were performed after abdominal delivery and one after vaginal delivery. The most common indication for hysterectomy was uterine rupture (13/19), followed by uterine atony (4/19). There was one case of intraoperative bladder injury. We had one maternal death because of septic shock. There were 13 cases of neonatal mortality. Conclusion:Postpartum hemorrhage and uterine rupture are the leading causes of maternal mortality and morbidity and represents the most challenging complication that an obstetrician will face.