Peripartum hysterectomy and its risk factors

  • Renuka Tamrakar Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
  • Upendra Pandit Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
  • Sabita Shrestha Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
  • Basant Sharma Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
  • Rakshya Joshi Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal
Keywords: Cesarean hysterectomy, Peripartum hyterectomy, Postpartum hysterectomy

Abstract

Background: Emergency Peripartum Hysterectomy (EPH) is an important lifesaving surgical procedure considered in cases of severe hemorrhage unresponsive to medical and conservative management. The objective is to review incidence, identification, intervention and impact of emergency peripartum hysterectomy.

Methods: The retrospective, cross-sectional study designed was to used. EPH data were collected from January 2014 to December 2018.Descriptive statistics was used to analyzed data and presented in tables and charts.

Results: Incidence of Emergency Peripartum Hysterectomies was 2.3% out of 252(2.6%) cases of obstetrical emergencies and 0.06% that is 1 in 1600 deliveries. Most common indications for EPH were uterine rupture (33.3%); placenta accreta (33.3%) followed by retained placenta (16.6%) and endometritis with pyometritis (16.6%). Estimated blood loss 1916 ml., timeliness from delivery to hysterectomy was 140 minutes; most common post-operative complication was surgical site infection (33.3%) and length of hospital stay 11.7 days. Maternal morbidity rate was 33.3%. There was no maternal mortality recorded.

Conclusions: The timely intervention improves the outcome in Peripar­tum Hysterectomy, which is frequently associated with abnormal placen­tation as a consequence of increasing caesarean deliveries rate.

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Author Biographies

Renuka Tamrakar, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Department of Obstetrics and Gynecology

Upendra Pandit, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Department of Obstetrics and Gynecology

Sabita Shrestha, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Department of Obstetrics and Gynecology

Basant Sharma, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Department of Obstetrics and Gynecology

Rakshya Joshi, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan, Nepal

Department of Obstetrics and Gynecology

Published
2019-03-31
How to Cite
Tamrakar, R., Pandit, U., Shrestha, S., Sharma, B., & Joshi, R. (2019). Peripartum hysterectomy and its risk factors. Journal of Chitwan Medical College, 9(1), 27-31. https://doi.org/10.3126/jcmc.v9i1.23779
Section
Original Research Articles