Emergency obstetric hysterectomy is a life saving procedure in severe obstetrical hemorrhage.
To review frequency, indications, associated risk factors and maternal morbidity and mortality associated with emergency obstetric hysterectomy done in Al- Elwiya maternity teaching hospital-Baghdad
PATIENTS AND METHODS:
A prospective study carried out from January the 1st 2010, to December 31st 2010.Maternal parameters analyzed were age, parity, booking status, setting, anemia& pre existing diseases, history of traditional birth attendants interference, mode of delivery, history of caesarean section, time of arrival to hospital and postpartum state of on arrival, frequency ,indications of emergency obstetric hysterectomy, associated maternal morbidity and mortality.
During the study period ; 200 cases developed postpartum hemorrhage out of 17150 deliveries. Thirty-one cases ended by emergency obestetric hysterectomy and 169 cases were conservatively managed medically or surgically, giving an incidence of 1.8/1000 deliveries.Emergency obestetric hysterectomy following vaginal delivery was 0.11% and following cesearean section was 0.27%. Majority of patients were un booked 77.41% and their age group 25-42years. Common parity was 3 and 4. Morbidly adherent placenta was commonest indication of emergency obestetric hysterectomy ; 51.61% , rupture uterus 22.60% , atony of uterus 12.90% , broad ligament heamatoma 9.67% .Out of 31 cases; 15 cases had traditional birth attendant interference 48.38%.All cases required blood transfusion and admission to intensive care unit. Out of 31 cases; 2 maternal deaths 6.45% . Total hysterectomy performed in 20 patients, and subtotal in 11 .
Emergency obstetric hysterectomy is a life saving, surgical procedure to arrest intractable obstetric hemorrhage .It brings down maternal mortality when performed in selected cases at appropriate time. Identification of risk group , planned delivery and timely referral of risk parturient; can minimize its performance .