Incidence and risk factors of emergency peripartum hysterectomy: A cross-sectional study from a single tertiary care maternity hospital

Abstract

Background: Emergency peripartum hysterectomy (EPH) is a life-saving surgical surgery performed during or after childbirth to preserve the lives of women and newborns in life-threatening conditions. It is linked to high rates of maternal morbidity and mortality. This study aimed to determine the incidence and risk factors for EPH at a tertiary care maternity hospital in Jammu and Kashmir, India. Methods: Between January 2020 and December 2022, retrospective descriptive cohort research was carried out. All pregnant patients scheduled for delivery at the Obstetrics and Gynecology department of SMGS, GMC Jammu, were included in the study. Maternal demographics, medical and obstetric history, EPH indications, surgical and obstetric care, and maternal and newborn outcomes were all gathered from medical records and hospital databases. Descriptive analysis and statistical tests were performed using SPSS Statistics. Results: The study comprised 104 cases of EPH, with an incidence of 2.40/1000 deliveries. The usual maternal age at delivery was 36 years, and the median number of children was two. Previous cesarean delivery was a substantial risk factor, with at least one previous cesarean in 69.2% of cases. The most common cause of EPH, accounting for 73.0% of cases, was aberrant placentation. Less common indicators were uterine atony, uterine rupture, uterine myoma, and placental abruption. Total hysterectomy was performed in 83.3% of cases, with general anesthesia being the predominant type of anesthesia. The median estimated blood loss was 2100 mL, and intraoperative complications were observed in 29.8% of cases. No maternal deaths were reported. Conclusion: In the examined cohort, the incidence of EPH was 2.40/1000 deliveries. Abnormal placentation, including placenta previa and placenta accreta spectrum, as well as previous cesarean birth, were significant risk factors for EPH.