Maternal and fetal outcomes following emergency obstetric hysterectomy in a tertiary care center- A cross-sectional study.
DOI:
https://doi.org/10.51168/sjhrafrica.v6i6.1910Keywords:
Pregnancy, Emergency Obstetric Hysterectomy, Atonic, Postpartum hemorrhage, Placenta Accreata Spectrum, Life-threatening complicationsAbstract
Background: When choosing to perform an emergency obstetric hysterectomy, the surgeon faces more challenges than in any other obstetrical or gynecological procedure. It is frequently a very tough choice that calls for sound professional judgment. However, due to the growing frequency and trend of Caesarean deliveries worldwide, placenta accreta has been highlighted in more recent reports as the most common indication.
Objectives- To assess the incidence, demographic profile, indications, risk factors, fetomaternal outcome, and problems related to emergency obstetric hysterectomy.
Materials and methods: The study was a prospective, cross-sectional study. The study was carried out at Baba Raghav Das Medical College in Gorakhpur, Uttar Pradesh, India, a tertiary referral hospital, for a period of two years, from August 2019 to August 2021. A total of thirty-six cases of emergency obstetric hysterectomy were enrolled during the study period.
Results: The study observed an overall incidence of 3.48 per 1000 deliveries for emergency obstetric hysterectomy, with a higher rate following caesarean sections (5.70 per 1000 deliveries). Most women were aged 21–30 years (50%) and were multigravida with a parity of 1–2. The majority (69.5%) underwent surgery at term (≥37 weeks). Placenta accreta spectrum (47.22%) and atonic postpartum hemorrhage (25%) were the most common indications. Significant maternal complications, including maternal mortality and notable neonatal morbidity, including NICU admissions and two neonatal deaths, were also recorded.
Conclusion: Only in cases where it’s life-threatening, near-miss cases, and preventive measures fail to arrest bleeding, an emergency obstetric hysterectomy needs to be performed. Placenta accreta spectrum is the most common indication noted recently.
Recommendations: Further investigation and the development of guidelines and protocols for high-risk cases require a greater number of participants and a multicenter study approach.
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