Published 21-09-2021
Keywords
- Peripartum hysterectomy,
- placenta accreta,
- postpartum hemorrhage
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This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Abstract
Background and Aims: We reviewed all peripartum hysterectomies at our institute over a 4 yearsperiod. The aim of this study was to determine the incidence, risk factors, indications and outcomesof peripartum hysterectomies. Material and Methods:This was a retrospective analysis of recordsof women who underwent emergency or elective peripartum hysterectomy in Sher-E-BanglaMedical College Hospital over a span of 4 years (Jan’2016 to Dec’2019). Association of variableswas based on Chi-square test. Results: Sixty One (61) women underwent peripartum hysterectomyduring the study period. The incidence was 2.19/1000 deliveries. In 20 (32.78%) cases, peripartumhysterectomy was planned electively while emergency hysterectomy was done in 41 (67.22%)cases. Main indications of peripartum hysterectomies were abnormal placentation (52.5%),Rapture Uterus (29.5%), atonic postpartum hemorrhage (PPH) (18%). The common maternalcomplications were wound infection, febrile illness and urologic injuries. There were 02 maternaldeaths following emergency peripartum hysterectomy done due to placenta percreta. Thirty Two(32) hysterectomies were performed after cesarean delivery and Twenty Nine (29) hysterectomieswere performed after vaginal delivery. Risk factors are Age (29.8) parity, previous history of C/Sand previous history of MR/Abortion. Conclusions: Postpartum hemorrhage is one of the leadingcauses of maternal mortality and morbidity and represents the most challenging complication thatan obstetrician will face. There are some risk factors for peripartum hysterectomy. The mostcommon indication was abnormal placentation (Placenta Acrreta). The date also illustrate theincidence of emergency peripartum hysterectomy increase significantly with prior cesareansection.
References
- A. C. Rossi, R. H. Lee, and R. H. Chmait, “Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review,” Obstetrics and Gynecology, vol. 115, no. 3, pp. 637–644, 2010.View at: Publisher Site | Google Scholar
- A. Kwee, M. L. Bots, G. H. A. Visser, and H. W. Bruinse, “Emergency peripartum hysterectomy: a prospective study in the Netherlands,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 124, no. 2, pp. 187–192, 2006.View at: Publisher Site | Google Scholar
- M. E. Akar, E. S. Yilmaz, B. Yuksel, and Z. Yilmaz, “Emergency peripartum hysterectomy,” European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 113, no. 2, pp. 178–181, 2004.View at: Publisher Site | Google Scholar
- M. Waterstone, S. Bewley, and C. Wolfe, “Incidence and predictors of severe obstetric morbidity: case-control study,” British Medical Journal, vol. 322, no. 7294, pp. 1089–1093, 2001.View at: Google Scholar
- World Health Organization. Evaluating the Quality of Care for Severe Pregnancy Complications, the WHO Near-Miss Approach for Maternal Health. World Health Organization. 2011 [Google Scholar]
- Umezurike CC, Feyi-Waboso PA, Adisa CA. Peripartum hysterectomy in Aba Southeastern Nigeria. Aust N Z J Obstet Gynaecol. 2008;48:580– 2. [PubMed] [Google Scholar]
- . Zeteroglu S, Ustun Y, Engin-Ustun Y, Sahin G, Kamaci M. Peripartum hysterectomy in a teaching hospital in the Eastern region of Turkey. Eur J Obstet Gynecol Reprod Biol. 2005;120:57– 62. [PubMed] [Google Scholar]
- Jou HJ, Hung HW, Ling PY, Chen SM, Wu SC. Peripartum hysterectomy in Taiwan. Int J Gynaecol Obstet. 2008;101:269– 72. [PubMed] [Google Scholar]
- Knight M, Kurinczuk JJ, Spark P, Brocklehurst P United Kingdom Obstetric Surveillance System Steering Committee. Cesarean delivery and peripartum hysterectomy. Obstet Gynecol. 2008;111:97– 105. [PubMed] [Google Scholar]
- Rahman J, Al-Ali M, Qutub HO, AlSuleiman SS, Al-Jama FE, Rahman MS. Emergency obstetric hysterectomy in a university hospital: A 25-year review. J Obstet Gynaecol. 2008;28:69– 72. [PubMed] [Google Scholar]
- Agrawal S, Yadav R, Raghunandan C, Dhingra S, Kaur H. Peripartum hysterectomy in a teaching hospital in India. Asian J Med Sci. 2013;4:5– 9. [Google Scholar]
- Korejo R, Nasir A, Yasmin H, Bhutta S. Emergency obstetric hysterectomy. J Pak Med Assoc. 2012;62:1322– 5. [PubMed] [Google Scholar]
- Kastner ES, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy: Experience at a community teaching hospital. Obstet Gynecol. 2002;99:971– 5. [PubMed] [Google Scholar]
- Kwee A, Bots ML, Visser GH, Bruinse HW. Emergency peripartum hysterectomy: A prospective study in the Netherlands. Eur J Obstet Gynecol Reprod Biol. 2006;124:187– 92. [PubMed] [Google Scholar]
- Sakse A, Weber T, Nickelsen C, Secher NJ. Peripartum hysterectomy in Denmark 1995-2004. Acta Obstet Gynecol Scand. 2007;86:1472– 5. [PubMed] [Google Scholar]
- saxena sv, bagga r, jain v, gopalan s. emergency peripartum hysterectomy. int j gynaecol obstet. 2004;85:172– 3. [pubmed] [Google Scholar]
- Flood KM, Said S, Geary M, Robson M, Fitzpatrick C, Malone FD. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol. 2009;200:632.e1 [PubMed] [Google Scholar]
- Chestnut dh, dewan dm, redick lf, caton d, spielman fj. anesthetic management for obstetric hysterectomy: a multiinstitutional study. anesthesiology. 1989;70:607– 10. [pubmed] [Google Scholar]