Sohail Mahmood, Aqueela Ayaz.
Obstetrical hysterectomy
J Surg Pak Sep 2005;10(3):20-3.
Bahawal Victoria Hospital, Bahawalpur
Objective: To find out indications and complications of all obstetrical hysterectomies performed in our unit Design: A case series Place & Duration: The study was done from January 2001 to December 2003 in Obstetrics and Gynecology unit II of Bahawal Victoria Hospital, Bahawalpur Patients and Method: The study included thirty two patients who underwent hysterectomy during a three year period. Records of all patients were analyzed for indications and complications. Results: Out of a total 9018 obstetrical admissions, 7407 patients delivered. This included 2083(28.12%) caesarean sections. Thirty two patients (0.432%) underwent emergency obstetrical hysterectomy. (1 in 231.4 deliveries). All obstetrical hysterectomies were performed as a last tool to control hemorrhage and was considered as a life saving procedure. Main indications were rupture uterus (53.120 and uncontrolled hemorrhage due to atonic uterus (21.810/6). Other indications included placenta previa (9.39%), infected puerperal uterus (9.3996) and pathologically adherent placenta (6.25%). Subtotal hysterectomy was done in 25 patients (78.12%) while 7 patients (21.87%) had total abdominal hysterectomy. Anemia (100%) and pyrexia (78.13%) were the major post op complications. Despite multiple serious complications 26 patients (81.25%) recovered completely while 6 (18,75%) maternal deaths occurred. Conclusion: The high number of obstetrical hysterectomies indicates the lack of knowledge and negligence among population about pregnancy and child birth. Adequate education of primary health providers, traditional birth attendants and early referral are essential to reduce this disaster.
Category: Obstetrics and Gynecology
Keywords: Hysterectomy. Uterus. Hemorrhage.
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