Retrospective Study of Emergency Obstetric Hysterectomy and Maternal and Perinatal Outcome

Background Emergency obstetrics hysterectomy, although rare in modern obstetrics, remains a life-saving procedure in cases of severe haemorrhage. Purpose of this study was to evaluate the incidence, risk factors, indications, outcomes, and complications of obstetrics hysterectomy performed in our hospital between June 2015 and June 2017. Methods The medical records of 36 patients who had undergone obstetrics hysterectomy, between June 2015 and June 2017 in civil hospital, Ahmedabad, were scrutinized and evaluated retrospectively. Maternal age, parity, gestational age, characteristics of the present pregnancy and mode of delivery, indications of hysterectomies, operative complications, postoperative conditions, and maternal and neonatal outcomes were noted and evaluated. Results There were 36 obstetrics hysterectomies out of 15, 682 deliveries, a rate of 0.22 per 1, 000 deliveries. Twenty seven hysterectomies were performed after caesarean delivery and nine after vaginal delivery. The most common indication for hysterectomy was uterine atony 36 % (13/36), followed by rupture uterus 30.5 % (11/36), placenta previa 13.8 % (5/36), retained placenta 13.8 % (5/36) and placenta percreta 5 % (2/36). We had five maternal deaths. Conclusion Obstetrics hysterectomy is a necessary life- saving procedure. Uterine atony was one of the leading causes of emergency obstetrics hysterectomy from my study. Other risk factors were massive haemorrhage due to abnormal placentation, placenta previa and uterine rupture associated with multiparity and previous Caesarean section. Availing of proper antenatal care, identification of high risk cases and timely referral to proper institution can avoid the complications resulting from massive haemorrhage, abnormal placentation and rupture uterus. Emergency obstetrics hysterectomy being the treatment of choice in some of these cases can thereby reduce maternal morbidity and mortality.