A Retrospective Study on Emergency Obstetric Hysterectomy in a Tertiary Care Hospital

Introduction: Emergency obstetric hysterectomy (EOH) is defined as removal of the uterus at the time of caesarean section or following vaginal delivery or within the puerperium period, or for complications following pregnancy termination such as perforation and sepsis. It is a necessary evil in our obstetric practise as on one hand the patients future reproductivity is sacrificed but on the other hand it is a lifesaving procedure in the face of life-threatening haemorrhage Aims and objectives: This study analysed the incidence of emergency obstetric hysterectomy in a tertiary care hospital and the indication and risk factors associated; the complications during and after the surgery and associated morbidity, mortality and outcome in the patients undergoing the surgery Material and methods: This retrospective observational study was performed in the department of Obstetrics and Gynecology in KIMSH and data was collected from the Medical Records Section over a 5 year period from June 2014-May 2019. Detailed history and appropriate data was collected from operation theatre records and casefile. Each patients case record was analysed with regard to age, parity, ante natal high risk factors, indication and type of hysterectomy, complications during and after the surgery and the final feto-maternal outcome. Results: The incidence of emergency obstetric hysterectomy in our study was 0.15 % with maximum number of patients belonged to age group of 21-25 years; atonic PPH (40 %) and adherent placenta (40 %) were the most common indications for emergency hysterectomy.40 % underwent total and 60 % underwent subtotal hysterectomy. All patients received transfusion of multiple blood products, 80 % required ICU care and there was one mortality. Conclusion: Obstetric hysterectomy is a lifesaving procedure when decided upon at the correct time and can be prevented by timely referral of high risk cases to tertiary care centr