Obstetric hysterectomy, still a life saving tool in modern day obstetrics: a five year study

Abstract

Background: Objective of current study was to study the indications and maternal outcome of emergency obstetric hysterectomy and its role in reduction of maternal morbidity and mortality in complicated obstetric cases. Methods: A prospective study of the cases of emergency obstetric hysterectomy performed over a period of five years from 2009 to 2013 was done. Results: During the study period, 105 emergency obstetric hysterectomies were performed giving an incidence of 0.54% .The incidence of hysterectomy following vaginal delivery was 0.54% and that of caesarean hysterectomy was 2.08%. It was most common in the age group 26-35 years (66.66%) and in women of parity 3-4 (71.42%).Rupture uterus was the most common indication accounting for 59.04% cases followed by Atonic PPH (18.09%). Febrile illness and wound infection were the two most common co-morbidities. Maternal mortality was 5.71%. Conclusions: Emergency obstetric hysterectomy is potentially a life saving procedure which every obstetrician must be familiar with in cases of catastrophic rupture uterus and intractable haemorrhage. With the help of prostaglandins, modern policies of active management of labor, timely performance of caesarean section, internal iliac artery ligation, compression sutures etc. obstetric hysterectomy should be made a more rare procedure.