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Indian Journal of Obstetrics and Gynecology

Volume  5, Issue 3 (Supplement), Jul-Sep 2017, Pages 304-304
 

Original Article

Study of Emergency Obstetric Hysterectomy

Reshma Ravindran,Annie Rajaratnam

Reshma Ravindran 3rd year postgraduate, Department of Obstetrics and Gynecology, Yenepoya Medical College & Hospital, Mangalore, Karnataka, India. Annie Rajaratnam Associate Professor, Department of Obstetrics and Gynecology, Yenepoya Medical College & Hospital, Mangalore, Karnataka, India.

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Abstract

Introduction: Obstetric hysterectomy is a hysterectomy performed on a gravid uterus during pregnancy, labour or puerperium. In no other gynecological or obstetrical surgery is the surgeon in as much a dilemma as when deciding to resort to an emergency hysterectomy. On one hand it is the last resort to save a mothers life,and beside the mothers reproductive capability is sacrificed. Objective: To study indications and maternal outcome of emergency obstetric hysterectomy. Methods: A prospective study of the cases of obstetric hysterectomy performed over a period of 3 years from 2014 to July 2017 in Yenepoya Medical College hospital. Evaluation of Maternal age, parity, booking status, obstetric risk factors, duration of hospital stay, indications of hysterectomy, type of hysterectomy, intra-op and post-operative complications, blood transfusions and maternal morbidity and mortality was done. Results: During the study period there were 7246 deliveries of which 8 required emergency obstetric hysterectomy with an incidence of 0.11%. It was more common in multipara (0.11%). Adherent placenta (62.5%) and post partum hemorrhage (37.5%) were the common indications. All were total abdominal hysterectomies. No maternal mortality was noted in all cases. Conclusion: Emergency obstetric hysterectomy is a lifesaving procedure. The maternal outcome greatly depends on timely decision and good clinical judgment because unnecessary delay can cost life and undue haste can cause morbidity. Active management of 3rd stage of labour, early recognization of complications, blood transfusion facilities are very important measures to be taken to prevent maternal mortality.