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Objectives: To find out the frequency, indications, preoperative morbidity and mortality of Emergency Peripartum
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.
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