Clinical Audit of Obstetric Hysterectomy in a Tertiary Care Centre: An Observational Retroprospective Study

Abstract

Purpose of study: The purpose of this study is to analyse the profile and characteristics of patients who may undergo obstetric hysterectomy, to study the intra-operative and post-operative complications of these patients and to increase the preparedness and reduce morbidity and mortality of patients undergoing obstetric hysterectomy.

Methods: After taking approval of the IEC, data of patients who had consented to be a part of the study were collected and analysed.

Results: Our study included 30 patients. Twenty-two patients underwent emergency obstetric hysterectomy, with abnormal placentation being the most common indication followed by post-partum haemorrhage. The most common postoperative complication was bladder injuries, and two out of 30 patients eventually succumbed in the post operative period.

Conclusion: Most of the morbidity associated with OH is attributed to the indications for which OH is done rather than the procedure itself. The indication for obstetric hysterectomy has changed to abnormal placentation from uterine atony and rupture. Future studies and change in management practices should focus on reducing the rate of caesarean sections whenever possible with proper preoperative planning, designing appropriate labour unit protocols and setting up multi-disciplinary units to manage difficult cases.

Keywords: Abnormal placentation; Caesarean sections; Obstetric hysterectomy; Rupture.