Emergency Peripartum Hysterectomy - A Study at Tertiary Care Center, Jodhpur, Western Rajasthan

Background: Post-partum hemorrhage is a significant cause of maternal mortality and morbidity. The objective of the study was to evaluate the incidence, predisposing factors& associated complications and outcome of emergency peripartum hysterectomy. Methods: It is a prospective analysis of emergency peripartum hysterectomy conducted at tertiary care center at Umaid Hospital Jodhpur, Western Rajasthan between Jan 2017 to December 2018. Results: 41 women underwent peripartum hysterectomy among 43552 deliveries, accounting to an incidence of 0.094 %. Incidence of subtotal hysterectomy after vaginal deliveries was higher as compared to cesarean deliveries. The most common indications were uterine rupture (scarred and unscarred uterus) 56.09 % (23), uterine atony 41.4 (17.07 %). Post- operatively 17.07 % patients developed DIC (7), 17.07 % patients developed febrile illness (7), 9.75 % patients of ruptured uterus experienced injury to the bladder (4). Maternal mortality in this study was 12.1 % (5 %). Conclusions: Hysterectomy is a lifesaving procedure to control postpartum hemorrhage, but is associated with significant maternal morbidity and mortality. Uterine atony, uterine ruptures, placenta previa were identified as risk factors. . Hence only proper awareness, timely referral and correction of anemia are the key factors to be addressed in this part of the state.