Critical Analysis of Peripartum Hysterectomies at Tertiary Care Centre of Northern India.

Aim: Peripartum hysterectomy is defined as removal of uterus at the time of delivery or in immediate postpartum period till 6 weeks. This study had been performed to critically evaluate the incidence, indications, maternal and neonatal morbidity and mortality associated with peripartum hysterectomies so that corrective measures both preventive and treatment may be implicated for benefit of women health.

Method: A retrospective observational study in the Department of Obstetrics and Gynaecology, from 1st January 2013 to 31st December 2022, was conducted after obtaining ethical clearance. Information about all women, who had peripartum hysterectomy obtained from the medical case sheets, were recorded in a structured format which included demographic details, indication of peripartum hysterectomy, maternal and foetal outcome, per operative and postoperative complications, requirement of blood transfusion and need of ventilator support. Statistical analysis was done using the software package SPSS 28 for Windows.

Results: Total 478 peripartum hysterectomies were performed during study duration. Incidence of peripartum hysterectomy at our centre was 6.4 per thousand deliveries. 45.8% (219/478) cases of peripartum hysterectomy had rupture uterus. Second most common cause was morbid adherent placenta which was in tune of 19%. Other causes were uterine atony, placenta previa and postpartum sepsis. 47.2% patients required ICU care, 1.25% had bladder injury, 10% had septicaemia, 0.8% required relaparotomy and 57.9% had still birth.

Conclusion: Although peripartum hysterectomy is uncommon procedure but it is lifesaving procedure so every obstetrician must have expertise in this procedure.