Emergency Peripartum Hysterectomy During COVID-19 Pandemic

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.

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Emergency peripartum hysterectomy: a retrospective study at a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20161009 ◽

2016 ◽

pp. 1322-1326

Author(s):

Ranjana Patil ◽

Anupama Dave

Keyword(s):

Retrospective Study ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Peripartum Hysterectomy ◽

Emergency Peripartum Hysterectomy

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Emergency Peripartum Hysterectomy as Postpartum Hemorrhage Treatment: Incidence, Risk factors, and Complications

Journal of Nepal Medical Association ◽

10.31729/jnma.2375 ◽

2014 ◽

Vol 52 (193) ◽

pp. 668-676 ◽

Cited By ~ 3

Author(s):

Meena Pradhan ◽

Yong Shao

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Blood Loss ◽

Postpartum Hemorrhage ◽

Placenta Previa ◽

Uterine Atony ◽

Previous Caesarean Section ◽

Peripartum Hysterectomy ◽

Incidence Risk ◽

Emergency Peripartum Hysterectomy

Introduction: The aim of the research was to investigate incidence, risk factors, and complications associated with emergency peripartum hysterectomy, the ultimate treatment method for intractable postpartum hemorrhage.Methods: This is a single center case-control study conducted in Chongqing city in central China from 1st January 2007 to 31st December 2012 for emergency peripartum hysterectomy performed as a treatment of postpartum hemorrhage both in caesarean and vaginal delivery cases. While the study group included emergency peripartum hysterectomy (n=61) due to intractable postpartum hemorrhage, the control group included no hysterectomy (n=333) during the same study period.Results: We found 61 cases recorded for emergency peripartum hysterectomy for intractable postpartum hemorrhage. Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries. Emergency peripartum hysterectomy as treatment of intractable postpartum hemorrhage include the followings: (i) blood loss 1000-2000 ml, crude odd ratio (OR) =18.48 (95% CI 5.1-65.7), adjusted odd ratio (AOR) = 9.1 (95% CI 2.2-37.7); (ii) blood loss >2000 ml, OR = 152 (95% CI 43.7-528.4), AOR = 45.3 (95% CI 11.6-176.9); (iii) previous caesarean section, OR = 5.5 (95% CI 2.9-9.7), AOR = 3.7(95% CI 1.4-9.9); (iv) uterine atony, OR = 11.9 (95% CI 5.8-24.6), AOR = 7.5 (95% CI 1.8-30.2); (v) placenta previa, OR = 2.04 (95% CI 1.1-3.5), AOR = none. Conclusions: Emergency peripartum hysterectomy is the last resort as treatment of intractable severe postpartum hemorrhage. Our study depicts that severe post partum hemorrhage, further dreaded complex events for emergency peripartum hysterectomy, has significant association with placental factors, previous caesarean section, and uterine atony. Pathologically, placenta accreta remained the most leading cause of hysterectomy.Keywords: caesarean section; hemorrhage; peripartum hysterectomy; placenta previa.

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Emergency peripartum hysterectomy: A 10-year review at the Royal Hospital for Women, Sydney

Yearbook of Anesthesiology and Pain Management ◽

10.1016/j.yane.2011.08.032 ◽

2012 ◽

Vol 2012 ◽

pp. 316-317

Author(s):

D.H. Chestnut

Keyword(s):

Royal Hospital ◽

Peripartum Hysterectomy ◽

Emergency Peripartum Hysterectomy

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Peripartum hysterectomy and its risk factors

Journal of Chitwan Medical College ◽

10.3126/jcmc.v9i1.23779 ◽

2019 ◽

Vol 9 (1) ◽

pp. 27-31

Author(s):

Renuka Tamrakar ◽

Upendra Pandit ◽

Sabita Shrestha ◽

Basant Sharma ◽

Rakshya Joshi

Keyword(s):

Placenta Accreta ◽

Length Of Hospital Stay ◽

Cross Sectional Study ◽

Morbidity Rate ◽

Sectional Study ◽

Cross Sectional ◽

Peripartum Hysterectomy ◽

Estimated Blood Loss ◽

Severe Hemorrhage ◽

Emergency Peripartum Hysterectomy

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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