Emergency Obstetric Hysterectomy: A Retrospective Study from Obstetrics and Gynecology Hospital – Duhok over Three Years 2017 to 2019

Abstract

Background & Objectives: This study aimed to identify the indications and types of emergency obstetric hysterectomy that were applied in obstetrics and Gynecological Duhok Hospital. Methods: In this retrospective cross-sectional study, the medical records of the patients who underwent emergency obstetric hysterectomy were reviewed for medical indications and outcomes between the 1st of January 2017 and 31st December 2019. Results: The mean age of the patients was 33.81±5.48 ranged from 18 to 42 years old. Most of the patients delivered by cesarean section (89.6%) and the remaining by normal vaginal delivery (10.4%). Some of the patients had a total abdominal hysterectomy ((54.2%) and others had a subtotal hysterectomy (45.8%). The indications of hysterectomy were morbidly adherent placenta (56.3%), atonic postpartum hemorrhage (12.5%), uterine rupture (12.5%), abruptio placentae (8.3%), placenta previa (8.3%). The most common maternal complications were bladder injury (18.8%) followed by intensive care unit admission (8.3%) and mortality (8.3%) and the majority of patients had more than one complication (39.6%) and 25.0% had no complication. The most common fetal complication was mortality (25.0%) followed by neonatal intensive care unit admission (16.7%) and 58.3% had no complication. Conclusion: This study found that morbidly adherent placenta was the most common indication for emergency obstetric hysterectomy. Bladder injury and neonatal intensive care unit admission were the most common maternal and fetal complications, respectively. This study showed that the incidence of previous cesareans section was high in women who underwent a hysterectomy.