DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160395

A clinical review of obstetric hysterectomies done in medical college, Kottayam for a period of six years

Surya Jayaram, Acka Priya Varghese

Abstract


Background: Obstetric/peripartum hysterectomy is a hysterectomy performed for any indication during pregnancy, labour or puerperium. It is important to know the general incidence, changing trends and indications of this surgery. The objective of the study is to find out the incidence of obstetric hysterectomy, type of obstetric hysterectomy done, indications of the procedure, maternal clinical profile, postoperative complications and the maternal and fetal outcome.

Methods: A retrospective, descriptive case series study of all pregnant women who underwent hysterectomy in a six year period has been done.

Results: 57 women underwent hysterectomy. The incidence of obstetric hysterectomy in this study is 0.17%. Mean age of the women was 30.3 years. Mean parity was two. 1.75% of cases were unbooked. 24.56% of cases underwent obstetric hysterectomy following vaginal delivery and 74.44% of cases had the procedure following abdominal route of delivery. 56.14% of cases underwent obstetric hysterectomy for postpartum hemorrhage, 36.84% underwent it for morbidly adherent placenta. 90.47% of morbidly adherent placenta had previous caesarean section as a major risk factor. 12.3% of mothers died postoperatively.

Conclusions: By good obstetric practices, proper diagnosis of morbidly adherent placenta, bringing down the number of unnecessary caesarean section the incidence of this procedure can be brought down.


Keywords


Obstetric hysterectomy, Adherent placenta, Caesarean section, Route of delivery

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References


Whiteman MK, Kuklina E, Hillis SD, Jamieson DJ, Meikle SF, Posner SF. Incidence and determinants of peripartum hysterectomy. Obstetrics & Gynecology. 2006;108(6):1486-92.

Knight M. Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage. BJOG: An International Journal of Obstetrics & Gynaecology. 2007;114(11):1380-7.

Praneshwari Devi RK, Singh N, Singh D. Emergency Obstetric Hysterectomy, a study of 26 cases over a period of 5 years. Journal of Obstet Gynecol Ind. 2004;54:343-5.

Singh R, Nagrath A. Emergency obstetric hysterectomy – a retrospective study of 51 cases over a period of 5 years. Journal of Obstet Gynecol India. 2005;55(5):428-30.

Sahu L, Chakravertty B, Panda S. Hysterectomy for Obstetric Emergencies. Obstet Gynecol Ind. 2004;54(1):34-6.

Marwaha P, Kaur M, Gupta A. Peripartum hysterectomy A five year study. Journal of Obstet Gynecol India. 2008;58(6):504-6.

Kant A, Wadhwani K. Emergency obstetric hysterectomy. Journal of Obstet Gynecol India. 2005;55(2):132-4.

Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy: experience at a community teaching hospital. Journal of Obstet Gynecol. 2002;99(6):971-5.

Clark SL, Yeh SY, Phelan JP, Bruce S, Paul RH. Emergency hysterectomy for obstetric haemorrhage. Obstet Gynecol. 1984;64(3):376-80.

Zorlu CG, Turan C, Işik AZ, Danişman N, Mungan T, Gökmen O. Emergency hysterectomy in modern obstetric practice Changing clinical perspective in time. Acta Obstet Gynecol Scand. 1998;77(2):186-90.

Okafor UV. Emergency Postpartum Hysterectomy for Uncontrolled Postpartum Bleeding. A Systematic Review Obstetrics & Gynecology. 2010;116(6):1453.