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A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention

Introduction Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that plays a critical role in managing life-threatening obstetric emergencies. In our study, we sought to evaluate the incidence, indications, risk factors and maternal as well as fetal outcomes associated with EOH. Also,...

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Autores principales: Verma, Aruna, Sharma, Garima, Kashyap, Monika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632065/
https://www.ncbi.nlm.nih.gov/pubmed/37946885
http://dx.doi.org/10.7759/cureus.46758
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author Verma, Aruna
Sharma, Garima
Kashyap, Monika
author_facet Verma, Aruna
Sharma, Garima
Kashyap, Monika
author_sort Verma, Aruna
collection PubMed
description Introduction Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that plays a critical role in managing life-threatening obstetric emergencies. In our study, we sought to evaluate the incidence, indications, risk factors and maternal as well as fetal outcomes associated with EOH. Also, the study was conducted to review the operative experiences and trend of emergency hysterectomies done for various indications over a period of two years in our tertiary care center. Methods The present hospital-based retrospective analytical study was conducted in the Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, between March 2021 to February 2023. All women who delivered within or outside the institute undergoing obstetric hysterectomy were included in our study. Out of a total of 7743 deliveries, 46 EOH cases were found. The data of these 46 EOH deliveries were collected and analyzed after issuing ethical clearance by the Institutional Ethical Committee of L.L.R.M. Medical College, Meerut. Results During the two-year study period, 46 EOH were performed out of 7743 deliveries making an incidence of 0.504 EOH per 100 deliveries. Most of the cases were of multiparous women in the age group of 25 to 35 years (78%). The majority, 43.5% cases belonged to placenta accreta spectrum (PAS), followed by ruptured uterus (30.5%) and postpartum hemorrhage (PPH) (26%). The most frequent preoperative complication seen in EOH was severe anemia (29, 63%). Intraoperative bladder injury was seen in four cases, along with one case of ureteric injury. Postoperatively, cases were shown to have acute hemorrhagic shock (54.3%), disseminated intravascular coagulation (DIC), septicemia, wound infection, acute renal failure (ARF), hepatic encephalopathy and psychosis. Four maternal mortalities were observed in our study. Conclusion EOH is a necessary operative procedure in many obstetric emergencies including PAS and PPH. Despite intra-operative risk and possible postoperative complications, it remains a potentially life-saving procedure. Thus various surgeries for PAS and PPH should be the integral part of postgraduate trainings to save the lives of mothers and to reduce the maternal mortality.
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spelling pubmed-106320652023-11-09 A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention Verma, Aruna Sharma, Garima Kashyap, Monika Cureus Obstetrics/Gynecology Introduction Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that plays a critical role in managing life-threatening obstetric emergencies. In our study, we sought to evaluate the incidence, indications, risk factors and maternal as well as fetal outcomes associated with EOH. Also, the study was conducted to review the operative experiences and trend of emergency hysterectomies done for various indications over a period of two years in our tertiary care center. Methods The present hospital-based retrospective analytical study was conducted in the Department of Obstetrics and Gynecology, L.L.R.M. Medical College, Meerut, between March 2021 to February 2023. All women who delivered within or outside the institute undergoing obstetric hysterectomy were included in our study. Out of a total of 7743 deliveries, 46 EOH cases were found. The data of these 46 EOH deliveries were collected and analyzed after issuing ethical clearance by the Institutional Ethical Committee of L.L.R.M. Medical College, Meerut. Results During the two-year study period, 46 EOH were performed out of 7743 deliveries making an incidence of 0.504 EOH per 100 deliveries. Most of the cases were of multiparous women in the age group of 25 to 35 years (78%). The majority, 43.5% cases belonged to placenta accreta spectrum (PAS), followed by ruptured uterus (30.5%) and postpartum hemorrhage (PPH) (26%). The most frequent preoperative complication seen in EOH was severe anemia (29, 63%). Intraoperative bladder injury was seen in four cases, along with one case of ureteric injury. Postoperatively, cases were shown to have acute hemorrhagic shock (54.3%), disseminated intravascular coagulation (DIC), septicemia, wound infection, acute renal failure (ARF), hepatic encephalopathy and psychosis. Four maternal mortalities were observed in our study. Conclusion EOH is a necessary operative procedure in many obstetric emergencies including PAS and PPH. Despite intra-operative risk and possible postoperative complications, it remains a potentially life-saving procedure. Thus various surgeries for PAS and PPH should be the integral part of postgraduate trainings to save the lives of mothers and to reduce the maternal mortality. Cureus 2023-10-09 /pmc/articles/PMC10632065/ /pubmed/37946885 http://dx.doi.org/10.7759/cureus.46758 Text en Copyright © 2023, Verma et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Obstetrics/Gynecology
Verma, Aruna
Sharma, Garima
Kashyap, Monika
A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title_full A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title_fullStr A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title_full_unstemmed A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title_short A Retrospective Analysis of Emergency Obstetric Hysterectomy: A Life-Saving Intervention
title_sort retrospective analysis of emergency obstetric hysterectomy: a life-saving intervention
topic Obstetrics/Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632065/
https://www.ncbi.nlm.nih.gov/pubmed/37946885
http://dx.doi.org/10.7759/cureus.46758
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