Tahira Fatima, Fazeela Ijaz Qayyum, Zunaira Tabassum.
Ten Years Experience and Review of Postpartum Hysterectomy Cases in Fauji Foundation Hospital Lahore.
Pak J Med Health Sci Jan ;13(1):37-9.

Background: Peripartum hysterectomy can save life and health of a mother in cases of unmanageable postpartum hemorrhage. Aim: To determine the incidence, indications, outcomes and complications of peripartum hysterectomy performed at Fauji foundation hospital, Lahore. Methods: Medical records of the patients who had postpartum hysterectomy, between January 2004 and December 2013, were reviewed retrospectively. The mode of delivery, indications for hysterectomy, intra operative and postoperative complications, maternal and feta outcomes were evaluated. Results: During this study period, there were 15 cases of postpartum hysterectomy out of 13,742 (1.09/1.000 deliveries). Out of these cases, 13 were performed after cesarean and 2 after vaginal deliveries. Postpartum hysterectomy was performed for abnormally adherent placenta previa in 12 cases (80%), for uterine atony in 2 (13.3%) ) and for uterine rupture in one case (6.7%). In addition to this, there were 2 cases of intra-operative bladder injury and 1 case of re-laparotomy due to continuous intra-peritoneal hemorrhage. Moreover 6 cases (40%) of disseminated intravascular coagulopathy were observed which were managed by pelvic packing. All patients required blood transfusions. Conclusion: The frequency of postpartum hysterectomy in this study was noted to be lower than the incidence in similar studies conducted in the majority of other under developed countries. The most frequent indication was morbidily adherent placenta previa.

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