TITLE:
Peripartum Hysterectomy in Misan Province during 2014-2016
AUTHORS:
Saba J. Al Heshemi
KEYWORDS:
Peripartum Hysterectomy, Primary Postpartum Hemorrhage, Rupture Uterus, Adherent Placenta
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.7 No.2,
February
28,
2017
ABSTRACT: Background: Peripartum hysterectomy is the procedure of removing the uterus after vaginal delivery or cesarean birth; it remains a life-saving procedure in cases of severe uterine hemorrhage. Objective: To know the incidence of peripartum hysterectomy in Misan province, what is the main cause of this procedure, and if there is any change in the incidence of this procedure during a 3 year study period. Method: A descriptive cross sectional study was done in Misan province for all cases of peripartum hysterectomy during the period from 2014-2016. All information regarding present pregnancy, previous obstetric history, the cause of peripartum hysterectomy, any complications & infant outcome, were taken from the case sheet & from the patients themselves. 50 patients were enrolled in this study, and only 30 patients needed peripartum hysterectomy and 20 patients’ uterus were saved by repair surgery. Results: During the study period of 3 years, there was 72,720 deliveries, and during that time 30 peripartum hysterectomies were carried out of the 50 cases studied, which gave an incidence of 0.4/1000 deliveries. The patients were diagnosed as: rupture uterus in 30 (60%) cases, adherent placenta in 14 (28%) & 6 (12%) cases had atonic uterus. The major postoperative complication was anemia which complicated 23 (46%) cases, & then bladder injury 5 (10%). Admission to ICU was needed for 24 (48%) cases. There were 32 (64%) cases needed ≥4 units of blood transfusion. There were 38 (76%) cases stayed in hospital for ≥4 days. The most common cause for peripartum hysterectomy was for adherent placenta (28%) & rupture uterus (20%). Conclusion: The incidence of peripartum hysterectomy was 0.4/1000 (0.04%) deliveries. The most common reason behind peripartum hysterectomy was for adherent placenta and next was for uterine rupture. The rate of this procedure was not changed during the study period.