Changing Trends in the Indications for Emergency Obstetric Hysterectomy at a Tertiary Care Hospital in Punjab

Objective: To evaluating shifting trends in indications for emergency obstetrical hysterectomy and its prevalence among patients at Services Hospital, Lahore, a tertiary care facility in Punjab Methodology: The study conducted in Services Institute of Medical Sciences included 55 patients undergoing emergency and elective caesarean sections necessitating obstetric hysterectomy. Additional variables such as age, parity, gestational age, and past obstetric history were noted using a proforma. The data was analyzed using SPSS software, version 25. Results: Indications for obstetric hysterectomy revealed that 67.27% of cases were attributed to morbidly adherent placenta (placenta accrete spectrum), 16.3% to uterine rupture, and 10.9% to uterine atony. Past obstetric history indicated that 18.1% of patients had prior vaginal deliveries, while 81% had previous caesarean sections, with 38% having undergone one caesarean section and 43% having had two or more caesarean deliveries. The mean age was recorded as 31.1 ± 3.39 years. Conclusion: The primary surgical indication for emergency obstetric hysterectomy was postpartum haemorrhage due to pathological placental embedment following previous caesarean sections. Therefore, it is imperative to closely regulate the rate of caesarean sections due to abnormal placental invasion and to reduce pregnancy-related death. Key Words: Emergency Obstetrical Hysterectomy (EOH), Morbidly Adherent Placenta, Postpartum