A Review of Cases of Peripartum Hysterectomy: Five Year Experience at Tertiary Care Centre in North India

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Dr. Pavika lal
Dr. Kiran Pandey
Dr. Shaily Agrawal
Dr. Renu Gupta
Dr. Garima Gupta

Abstract

Background: Peripartum hysterectomy is an emergency obstetric surgical procedure that results in the removal of the uterus after delivery of the foetus by caesarean section or following vaginal delivery, done to save the life of the mother.



Objective: To estimate the incidence, risk factors, indications and complications of peripartum hysterectomy.



Materials and Methods: This was a retrospective 5-year observational study at GSVM Medical College conducted between December 11, 2014 to December 10, 2019. All women who underwent a hysterectomy at the time of caesarean section or following vaginal delivery were enrolled in the study. Data was retrieved from medical records and was analyzed with respect to sociodemographic factors, risk factors, indications and associated morbidity and mortality.



Result: A total of 63 peripartum hysterectomies were performed. During the study leading indications for hysterectomy were adherent placenta (38%), rupture uterus (33.3%) and atonic postpartum haemorrhage (28.53%). The major associated risk factor was found to be Previous LSCS in 50/63 (79.3%) and 81% of the patients were unbooked, 22.22% patients required ICU/HDU care and 11.11% patients succumbed to death.



Conclusion: Proper antenatal check-ups, screening for risk factors and timely referral to higher centres can decrease the incidence of peripartum hysterectomy and associated morbidity and mortality.



Keywords: Peripartum hysterectomy; Indications; Complications; Risk factors; Morbidity

Published May 22, 2020

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