Abstract

Background: Obstetric hysterectomy is a life-saving procedure sometimes required for conditions such as postpartum hemorrhage and ruptured uterus. It is sometimes associated with both maternal and perinatal mortality.
Objective: To evaluate the incidence, indication, mortality, or morbidity associated with emergency obstetric hysterectomy in a tertiary care hospital.
Materials and Methods: The case records of all women who underwent emergency obstetric hysterectomy between January 2012 and December 2014 (a period of 3 years) were studied. Result: Of the total 8317 deliveries in a span of 3 years of the study period, 2036 underwent cesarean delivery (rate of 24.4%). A total of 33 obstetric hysterectomies were performed with a rate of 0.39% or 1 in 252 deliveries or 3.9 per 1000 deliveries. Most were in the age group of 21–30 years (19 cases, 57.6%). Majority of the patients were of second, third, or fourth parity (87.8%), 26 patients were unbooked. Most common causes of hysterectomy were rupture uterus due to obstructed labor, and morbid adherent placenta. There was no maternal mortality. Of the 33 deliveries, 18 (54.5%) resulted in perinatal mortality. Most common adverse event postsurgery was fever (30.3%), although 54.5% had no problems postsurgery. Conclusion: Most common indications for emergency obstetric hysterectomy are ruptured uterus and morbid adherent placenta. It is associated with good maternal prognosis and significant perinatal mortality. This could be avoided by good antenatal care and careful selection of patients for cesarean delivery as it has immense impact on both present and future child bearing.