Evaluation Of Emergent Periparum Hysterectomy Cases: A Six Year Experience

Objective: In this study, we aimed to investigate the incidence, indications, risk factors of emergent peripartum hysterectomy (EPH) and its effect on maternal mortality and morbidity. Design: Retrospective study Setting: Selcuk University, Meram Medical Faculty, Gynecology and Obstetric Department, Konya Patients: Thirty-seven EPH cases performed due to some obstetric complicatios were investigated retrospectively between January 2003 and April 2009. Interventions: Patient’s data, hospital records and other knowledges about patients were obtained from hospital archieves. Patient’s ages, parity, gravidy, gestational weeks and mode of deliveries were researched as demographic features. Operative records were also investigated. Main Outcome Measures: Incidence, indications and risk factors for peripartum hysterectomy. Results: A total of 37 cases were included in this study and the incidence of EPH was recorded as 0,223%. Total and subtotal hysterectomies were performed in 59,5% and 40,5% of the patients, respectively. Indications for hysterectomy were 43,2% atonia, 37,8% placenta previa, acreata and increata, 13,5% uterine rupture. Hysterectomies were performed in 54% of cases after caserean section, in 46% of cases after vaginal births. Oophorectomy and bilateral hipogastric arter ligation were performed in 8,1% and 51,3% of the patients, respectively. Three patients died, one due to multiple organ insufficiency and DIC. Conclusion: Uterin atonia is still the most common cause of postpartum hemorrhagia and EPH. EPH is a procedure with high mortality and morbidity but is life-saving when performed at suitable time