Evaluating the indications and outcomes of peripartum hysterectomy: A 10-Year retrospective study

Objective: This study aimed to evaluate the indications, surgical techniques, and outcomes of emergency peripartum hysterectomy (EPH) as a life-saving intervention at a tertiary care hospital. Methods: A retrospective analysis of 80 cases of EPH performed between June 2010 and June 2020 was conducted. Data were collected from patient medical records, focusing on demographic variables, surgical details, and postoperative outcomes. Results: The incidence of EPH was 2.5 per 1,000 deliveries. The mean age of patients was 33.5 ± 5.5 years, with a mean gravidity of 5.9 ± 2.8 and parity of 4.9 ± 2.5. Cesarean sections accounted for 50 cases, while 30 patients delivered vaginally. Subtotal hysterectomy was performed in 55 cases, and total abdominal hysterectomy in 25 cases. The primary indications for EPH were uterine atony, uterine rupture, and abnormal placentation. The average operation duration was 135.50 ± 40.10 minutes, with a mean blood transfusion requirement of 5.10 ± 3.05 units. Relaparotomy was necessary in 18 cases, and maternal mortality was observed in 8 cases. Postoperatively, 60% of patients required ICU admission. The mean hospital stay was 9.3 ± 4.2 days, with wound infection and sepsis occurring in 15% and 12.5% of cases, respectively. Conclusion: EPH remains a critical procedure in managing life-threatening obstetric hemorrhages, with uterine atony, rupture, and abnormal placentation being the leading indications. The high rate of EPH in this study may be associated with advanced maternal age and high parity.