Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

Gupta, Tejpal; Gupta, Saurabh; Deepika, Deepika; Gupta, Nidhi

doi:10.18203/2320-1770.ijrcog20172047

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…29 In India, this rate varies between 26% and 88.09%. 11,12,23,30 Total hysterectomy is indicated for placenta accreta, which is the main indication in developed countries. Indeed, subtotal hysterectomy is indicated if the source of the bleeding is upstream of the lower segment.…”

Section: Discussionmentioning

confidence: 99%

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Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

Tanjona

Romuald

Mahefa

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Postpartum hemorrhage is one of the leading causes of maternal death in the entire world. It affects 10% of deliveries. Emergency peripartum hysterectomy (EPH)defined as a lifesaving procedure involving the removal of the uterus to treat severe postpartum hemorrhage is one of the last-resort treatments for severe postpartum hemorrhage in case of failure of other techniques. Through this study, we aimed both to describe the epidemiological profile, to determine the etiologies, and maternal complications of EPH.Methods: It is about a descriptive retrospective study from January 1st, 2016 to January 1st, 2017 at the Befelatanana University Hospital of Obstetrics and Gynecology. We included all patients who underwent Emergency peripartum hysterectomy after 22 weeks of Amenorrhea (WA) regardless of the delivery route in the centre. We used the R software for the statistical analysis of the results.Results: We had 31 cases of EPH during this period with a prevalence of 0.44%. The average age was 26.38±5.61 years. Mean gestational age was 37±3.59 weeks of amenorrhea. In the 83.87% of cases, the patient received less than four prenatal consultations. Patients were referred in 45.16% of the cases. The delivery route was by cesarean section in 48.39% of cases. Eleven patients (35.48%) received a blood transfusion. Hysterectomy was subtotal in 96.77% of the cases. We had five (16.13%) maternal deaths during the study period. The leading cause of death was hemorrhagic shock (80%). The etiology of hysterectomy was dominated by uterine atony complicated by hemorrhage (48.39%), followed by retroplacental hematoma (25.81%) and uterine rupture (22.58%).Conclusions: EPH still holds its place in the management of postpartum hemorrhage in Madagascar. Maternal mortality remains high. Uterine atony was the most common indication for EPH. The prevention of postpartum hemorrhage by management of the third stage of labour should be carried out by any health actor.

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Section: Discussionmentioning

confidence: 99%

“…In India, maternal mortality ranges from 2.2% to 16.7%. [9][10][11][12]23,30 Studies in Africa have found a higher frequency. Obiecchina found up to 31% of maternal deaths, Nayama found 21.95% of deaths.…”

Section: Discussionmentioning

confidence: 99%

Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

Tanjona

Romuald

Mahefa

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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

MJ,

JM,

et al. 2024

BJKines - NJBAS

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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.

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Changing trends in incidence, type, indication and maternal outcome of peripartum hysterectomy over 10 years at a tertiary care centre

Cited by 2 publications

References 12 publications

Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

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

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