Emergency Obstetric Hysterectomy 10-Year Review at SKIIMS Srinagar, Kashmir

Abstract

BACKGROUND: Obstetric hysterectomy is removal of uterus during pregnancy, labour and puerpeurium. It is life saving procedure done to save the mother's life when she is having severe post-partum haemorrhage (PPH), rupture uterus or morbid adherent placenta and trauma.

OBJECTIVES: To review the incidence, maternal profile, indication of emergency obstetric hysterectomy, the maternal morbidity and mortality and perinatal mortality following this procedure.

METHODS: A retrospective analysis of emergency obstetric hysterectomy performed over a period of 10 years from 1997 to 2006 in the Obstetric and Gynaecology Department of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar was done.

RESULTS: During this period 22045 deliveries were conducted and amongst them 33 emergency hysterectomies were performed giving an incidence of 0.14%. It was most common in the age group of 30-35 years and in multiparous women (84.84%). The most common indication for obstetric hysterectomy was PPH (60.6%) followed by rupture uterus(24.24%). The maternal mortality was 12.1% and perinatal mortalitywas 20.60%.

CONCLUSION: Emergency obstetric hysterectomy is a life saving procedure in cases of intractable PPH and rupture uterus. Augmentation of healthcare facilities, the identification of high risk cases, early referral, timely performance of surgery and resort to procedures like internal artery ligation can reduce the incidence of obstetric hysterectomy. JMS 2012;15(2):149-52