FREQUENCY OF EMERGENCY OBSTETRICAL HYSTERECTOMY, ITS INDICATIONS AND MATERNAL OUTCOME IN SAIDU TEACHING HOSPITAL, SWAT.
DOI:
https://doi.org/10.52206/jsmc.2012.2.2.192-195Abstract
Background: Emergency obstetrical hysterectomy (EOH) is one of the most common major surgical
procedures performed in gynecology and obstetrics. It is a life saving procedure in case of severe
hemorrhage.
Aims and objectives. The objective of this study was to determine the frequency, indications and maternal
outcome of emergency obstetrical hysterectomy.
Study Design: Descriptive study.
Place and duration of study: Study was carried out in the department of Obstetrics and Gynecology, Saidu
Teaching Hospital, Swat from January 2007 to December 2011.
Patients and Methods: During the study period a total of 29570 patients were delivered. Out of those 254
patients underwent emergency hysterectomy. Records of all the patients were analyzed. The parameters
analyzed were age, parity, socioeconomic status, booking status, indication for operation, operative notes,
maternal outcome complications and post-operative status.
Results: Total numbers of deliveries during the study period were 29570 and 254 emergency obstetrical
hysterectomies were performed. Frequency being 0.86%, only 12% of pregnant women were booked.
Commonest indications of EOH were ruptured uterus in 90 women (35.43%), uterine atony in 82 women
(32.28%), placental abruption in 31 women (12.22%), couveliar uterus in 13 women (5.12%) and placenta
previa in 9 women (3.54%).Commonest maternal complications were urinary tract infection in 16(6.30%)
patients followed by disseminated intravascular coagulation (DIC) in 11 (4.33%) patients and 28(11.02%)
patients died. Regarding parity 140(55.12%) were multiparous, 103(40.55%) patients were grand
multiparous and 11(4.33%) patients were primiparous.
Conclusion: EOH, although a frequent life saving operation, was associated with significant maternal
mortality, mostly due to the effects of massive hemorrhage. The most frequent indication for EOH was
ruptured uterus followed by uterine atony and placenta previa.
Key words: EOH, Rupture uterus, maternal outcome, postpartum hemorrhage.
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