EMERGENCY PERIPARTUM HYSTERECTOMY IN A TERTIARY CARE HOSPITAL
Keywords:
Emergency, obstetric, Haemorrhage, Emergency Peripartum hysterectomy, Ruptured uterusAbstract
Objectives: To find out the frequency, indications, preoperative morbidity and mortality of Emergency Peripartum
Hysterectomy (EPH).
Material and Methods: This retrospective descriptive study was conducted in the Obstetric and Gynecology Unit of
Hayatabad Medical Complex, Peshawar from January 2007 to December 2009. All EPH done during the study period
were included. Data regarding maternal age, parity, booking status, referral history, clinical feature, mode of delivery,
indications and perioperative morbidity and mortality were recorded and analyzed.
Results: Total number of deliveries during the study period were 16245 and total number of patients with EPH were
fifty one giving rise to a frequency of 0.31% ( 3.1/1000). Mean age and parity was 35 years and 7 respectively. Majority
(94.21%) of patients were admitted through emergency. They were referred from periphery hospital in serious condition.
The main indication was ruptured uterus (30, 58.8%) followed by uterine atony (12, 23.5%) Subtotal Hysterectomy
done in all cases. All patients required blood transfusion, 36 (70.5%) patients received in shock, 21 (41.1%)
required ICU admission, 18 (35.2%) developed DIC. Renal failure occurred in 6 cases, febrile illness in 36 (70.5%)
and wound infection was in 21cases (41.1%). Maternal mortality occurred in 9 cases (17.6%). These were due to
severe hemorrhage leading to irreversible shock, renal failure and coagulopathy.
Conclusion: Frequency of EPH was high in this study. Advanced age, high parity and lack of antenatal care were
seen as high risk factor. Ruptured uterus due to ingudicious use of oxytocin by unskilled birth attendant remain the
main reason for EPH. It is associated with high maternal morbidity and mortality.
Downloads
Published
How to Cite
Issue
Section
License
All articles published in the Journal of Medical Sciences (JMS) are licensed under the Creative Commons Attribution 4.0 International License (CC-BY 4.0). Under the CC BY 4.0 license, author(s) retain the ownership of the copyright publishing rights without restrictions for their content, and allow others to copy, use, print, share, modify, and distribute the content of the article even for commercial purposes as long as the original authors and the journal are properly cited. No permission is required from the author/s or the publishers for this purpose. Appropriate attribution can be provided by simply citing the original article. The corresponding author has the right to grant on behalf of all authors, a worldwide license to JMS and its licensees in all forms, formats, and media (whether known now or created in the future), The corresponding author must certify and warrant the authorship and proprietorship and should declare that he/she has not granted or assigned any of the article’s rights to any other person or body.
The corresponding author must compensate the journal for any costs, expenses, or damages that the JMS may incur as a result of any breach of these warranties including any intentional or unintentional errors, omissions, copyright issues, or plagiarism. The editorial office must be notified upon submission if an article contains materials like text, pictures, tables, or graphs from other copyrighted sources. The JMS reserves the right to remove any images, figures, tables, or other content, from any article, whether before or after publication, if concerns are raised about copyright, license, or permissions and the authors are unable to provide documentation confirming that appropriate permissions were obtained for publication of the content in question.
