Urooj Malik, Shahina Ishtiaq, Sheeba Hussain, Nigar Sadaf, Zarnigah, Mehreen Yousaf, Rehana Yasmeen.
Peripartum Hysterectomy: a six year experience at a tertiary care centre.
Pak J Surg Jan ;36(4):349-53.

Objective: To assess the frequency, indications and peri-operative complications of peri partum hysterectomy in a tertiary care teaching hospital. Sett ing: Obstetric department of Ziauddin Hospital which is affiliated with Ziauddin University. Period of study: from January 2014 to September 2019 Study design: Retrospective cross sectional study. Material and Methods: All patients during the study period who underwent obstetric hysterectomy at Ziauddin Hospital were included in the study. 45 peri partum hysterectomies were performed. Case records were reviewed for socio-demographic characteristics of the patients, indications for the hysterectomy, previous mode of delivery and maternal outcome, in terms of mortality and peri operative morbidity. Results: The frequency of peri-partum hysterectomy was 0.157% during the study period. The mean age of patients was 31.88 +- 2.55years. 93.3% were multigravidas. Commonest indication was placenta accreta (62.2%) followed by uterine rupture (15.5%) and placenta previa (11.1%). Uterine atony and multiple fibroids were the cause in 4.4% each and endometritis in 2.2%. The commonest perioperative complication was hemorrhage which was encountered in 100% of cases and was >3000ml in 35.5% cases followed by injury to the urinary bladder in 36.6% and DIC in 26.6%. Other complications included broad ligament hematoma, unilateral salpingo oophorectomy, wound infection, sepsis, renal failure and ureteric ligation. Maternal mortality was 2.2%. Conclusion: Peripartum hysterectomy is a challenging surgery performed to save the life of the mother in life threatening hemorrhage. The most frequent indication was placenta accreta and the most commonly associated risk factor was previous cesarean section. The most common complication was hemorrhage followed by urinary tract injury. Maternal mortality was 2.2%.

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