Emergency Obstetrical Hysterectomy (One Yr Review) at Nishtar Hospital Multan

Abstract

Objective: The objective was to study the cases of obstetrical hysterectomy in one year period in the teaching hospital and to determine incidence, indications and maternal outcome of the patients and suggesting ways to improve outcome.

Study Design: Observational retrospective study.

Place and Duration of Study:  This study was conducted at Nishtar Hospital Multan from Feb 2011 to Feb 2012.

Materials and Methods: One year observational retrospective study of 71 consecutive cases of obstetrical hysterectomies performed during study period ( i.e. from Feb 2011 to Feb 2012) in Nishtar Hospital Multan were analyzed.

Results: Total number of deliveries conducted during study period were 10406 and 71 obstetrical hysterectomies were undertaken. Frequency of obstetrical hysterectomies being 0.68% and booked cases 39.43%. The most common cause of procedures were morbid adherence of the placenta, uterine atony and uterine rupture. Total hysterectomies were 57.74% and subtotal were 42.25%. Number of maternal deaths were 12.6%. Patients who died were in critical condition with massive blood loss, late arrival , dai handling and non availability of blood beacase of uncooperative attendants and malpractices of doing caesarean sections at peripheries without any indication.These were main factors for maternal mortality.

Conclusion: Emergency obstetrical hysterctomy remains essential life saving procedure especially for high risk cases. Proper antenatal care, early admission in labour ward, proper resuscitation and in time refferal, increase favour of normal deliveries and reduced caesarean section rates will go long way to reduce the incidence of this procedure.