Emergency Peripartum Hysterectomy and its Outcome in a Tertiary Care Hospital in Dhaka City, Bangladesh

Authors

  • Shahnaz Akhtar Associate Professor, Department of Gynae and Obstetrics, Ad-din Women’s Medical College, Dhaka, Bangladesh.
  • Kazi Morjina Begum Professor, Department of Gynae and Obstetrics, Ad-din Women’s Medical College, Dhaka, Bangladesh.
  • Rahima Khatun Anis Associate Professor, Department of Gynae and Obstetrics, Ad-din Women’s Medical College, Dhaka, Bangladesh.
  • Nasrin Sultana Associate Professor, Department of Gynae and Obstetrics, Ad-din Women’s Medical College, Dhaka, Bangladesh.
  • ANM Saiful Hasan Assistant Professor, Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical College, Faridpur, Bangladesh.
  • Humayra Begum Registrar, Institute of Child and Mother Health (ICMH), Matuail, Dhaka
  • Kashfi Rizwana Medical Officer, Department of Gynae and Obstetrics, Ad-din Women’s Medical College, Dhaka, Bangladesh.
  • Mohammad Abu Sayed Miah Assistant Professor, Paediatric Nephrology, Mymensingh Medical College, Mymensingh, Bangladesh.

DOI:

https://doi.org/10.3329/ssmcj.v31i2.69451

Keywords:

Peripartum hysterectomy, Postpartum haemorrhage, Maternal mortality, Uterine atony

Abstract

Introduction: Emergency peripartum hysterectomy (EPH) is a life-saving surgical procedure performed when medical and surgical conservative measures fail to control postpartum hemorrhage. EPH is a challanging but life saving obstetric procedure performed when medical and surgical conservative measures fail to control postpartum haemorrhage .The present study aimed to review the peripartum hysterectomies and to compare the incidence, indications and outcome of EPH.

Materials and Methods: This retrospective study was conducted at a tertiary care hospital in Dhaka, Bangladesh. Total 62 cases have taken, who had hysterectomy that was performed in Obstetric and gynaecology department of Addin Womens Medical College Hospital during the period between January 2020 and December 2022.

Result: There were total of 36371 deliveries over the study period and EPH was performed in 62 cases making an incidence of 0.408. In this study 33.8% patients were between 35 to 39 years. Here 45.16% had their parity between 2nd and 3rd child. Here 61.2% had previous history of caesarean section, 24.19% had previous history of antepartum haemorrhage, 74.19% cases intrapartum operation had done. Among 62 cases of EPH 77.4% cases subtotal hysterectomy had done. Here, among 62 cases of caesarean section 35.48% had placenta accrete and 20.96% had history of placenta previa with haemorrhage and 12.9% had severe PPH due to atony of uterus. 22.5% cases had fetal outcome of still born but 32.25% baby born alive. In this study 51.6% cases patients develop haemorrhage as perioperative complication, 19.5% develop shock but 100% required blood transfusion among which 50% were in post operative period. Here 6 out of 62 cases had bladder injury, 5 patients needed relaparotomy due to haemoperitoneum caused by vaginal cuff bleeding. Mortality rate was 4.83%.

Conclusion: Now a days the indication of EPH has changed from uterine atony to abnormal placentation. It is a most important obstetric surgery performed in life threatening haemorrhage. Involvement of an experienced obstetrician at an early stage of management and efforts should be taken to reduce morbidity and mortality.

Sir Salimullah Med Coll J 2023; 31: 107-111

Abstract
66
PDF
64

Downloads

Published

2023-10-31

How to Cite

Akhtar, S., Begum, K. M. ., Anis, R. K., Sultana, N. ., Hasan, A. S., Begum, H., Rizwana, K., & Miah, M. A. S. (2023). Emergency Peripartum Hysterectomy and its Outcome in a Tertiary Care Hospital in Dhaka City, Bangladesh. Sir Salimullah Medical College Journal, 31(2), 107–111. https://doi.org/10.3329/ssmcj.v31i2.69451

Issue

Section

Original Article