A Three Year Audit of Emergency Peri-Partum Hysterectomy at Lady Willingdon Hospital Lahore

Objective: The objective was to know the incidence, indications and outcome of emergency peripartum hysterectomy Study design: This study was a descriptive case series study. The study period was three years with effect from 01-01-2008 to 31-12-2010. It was conducted in Lady Willingdon hospital Lahore. Study design:-Descriptive case series. Setting: Department of Obstetrics & Gynaecology, Lady Willingdon Hospital Lahore. Duration of study: Three years with effect from 01-01-2008 to 31-12-2010 Sample size:-190 patients who underwent emergency peri partum hysterectomy out of 67368 total deliveries in the 3 year study period. Sampling technique:-Non probability: Convenience sampling. Results: 190 patients underwent emergency peri-partum hysterectomy out of 67368 deliveries in the study period. (Incidence 0.28 %) Caesarean hysterectomy was performed in 0.54% of patients (n 119) (total c sections 21889) and an emergency hysterectomy following a vaginal delivery was done in 0.15% cases (n 71) (total vaginal deliveries 45479). Uterine atony, placenta praevia and placenta accreta were the leading indications for peri-partum hysterectomy. A subtotal hysterectomy was performed in 30 cases. There were 20 maternal deaths. Conclusion: Grand multi-parity leading to uterine atony and repeat caesarean section leading to abnormal placentation were found to be the major risk factors for emergency peri-partum hysterectomy. Although the procedure is associated with serious morbidity & mortality, but still it is life saving as we were able to avoid 154 potential maternal deaths with the procedure.