A clinical study of cases of obstetric hysterectomy in a tertiary care centre

Abstract

Introduction -Obstetric hysterectomy is defined as, "Extirpation of uterus either at the time of caesarean section or following normal vaginal delivery or within the puerperal period or for any complications following pregnancy termination like perforation or sepsis .1" Though a lifesaving procedure in various obstetric emergencies to save the life of the mother, it sacrifices her reproductive potential. Aims & objectives -To study the incidence, indications, predisposing risk factors, maternal and fetal outcomes in cases of obstetric hysterectomy with Postoperative follow up of such cases up to 42 days after delivery. Materials & Methods-This was a descriptive study carried out in the Department of Obstetrics and Gynecology, Surat Municipal Institute of Medical Education & Research, Surat from 1st November 2020 to 31st October 2022 with sample size of 30. Results-During the study period there were 30 cases of obstetric hysterectomy out of 13034 deliveries giving an incidence of 2.3 per 1000 births. Majority of cases of obstetric hysterectomy were multigravida female (76.66%) belonging to the age group of 26-30 years (46.6%) of which booked patients were (56.6%) with regular ANC visits and 40% cases were referred from peripheral health centres. Traumatic PPH and placenta accreta were the common indications . Maternal mortality rate was 20%. Conclusion-Though obstetric hysterectomy is a lifesaving procedure, decision must be taken judiciously weighing the need to sacrifice the obstetric future of the patient in favour of patient life. Keywords: Obstetric hysterectomy, Post partum haemorrhage, Adherant placenta.