Abstract
Objective: To assess the incidence and indications of emergency obstetric hysterectomy (EOH).
Methodology: In this retrospective study, all medical records in the Department of Obstetrics and Gynecology, Aziz Fatima Teaching Hospital, Faisalabad, Pakistan were reviewed from January 2012 till December 2016. Women with 22 weeks or more of gestation, who had undergone EOH during/immediately after delivery or within the puerperium were included. Data were analyzed using SPSS version 22.
Results: Of the 15,742 included deliveries, 40 underwent EOH with incidence is 0.25%. There were 62.5% women of age 31-40 years, 37.5% were grand-multipara (parity ≥ 5), 62.5% cases were un-booked and 45% women had already taken an unsuccessful Daai trial before being referred to hospital. Severe anemia (Hb <8g/dL) was present in 62.5% women. Life-threatening postpartum hemorrhage (PPH) was the most common indication (47.5%) and placenta previa was the most common cause of PPH (47.5%). Other indications of EOH were morbidly adherent placentae (MAP) (27.5%), and uterine rupture (25%).
Conclusion: EOH is a major surgical procedure performed in settings of failure of medical management of life-threatening PPH, MAP, and uterine rupture. Antenatal risk anticipation, early peripartum interventions and improving the quality of obstetric healthcare will help reduce the incidence of this procedure.
