Sumera Tahir, Mahmood Aleem, Samina Akram.
Indication and maternal outcome of Emergency Peripartum Hysterectomy.
Pak J Med Sci May ;19(3):182-6.

Objectives: To analyze the maternal outcome of peripartum hysterectomy in badly handled cases with ruptured uterus and severe post partum haemorrhage. Design and Setting: A retrospective study carried out in Obstetric & Gynaecology Unit-II, Divisional Headquarter Hospital (D. H. Q.) Faisalabad over a period of two years. Subject: Thirty patients who underwent emergency peripartum hysterectomy during the study period of two years. Main Outcome Measures: Indications, associated maternal morbidity & mortality of peripartum hysterectomy. Results: There were 30 cases of emergency peripartum hysterectomy over a period of two years. The most common indication was uterine rupture (42.9%), followed by uterine atony (26.6%). All women required blood transfusion, five (17%) developed coogulopathy, four (13.3%) had bladder injuries, two (6%) required salpingoophorectomy for uncontrolled adnexal bleeding and two (6%) patients underwent a repeat laparotomy for internal haemorrhage. Maternal mortality was 6% (n=2). Conclusion: Peripartum hysterectomy continues to have a high incidence in our community. High parity, illiteracy & ignorance coupled with inadequate maternity services, injudicious use of syntocinon, improper third stage management, abnormal placentation & uterine atony were identified as risk factors for emergency peripartum hysterectomy. An early decision of obstetrician can save blood loss & prevent complications.

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