Clinical analysis of 52 obstetric hysterectomies

Abstract

Objectives: Analysis of obstetric (peripartum and postpartum) hysterectomies with regard to their frequency, indications, complications, and risk factors.

Material and methods: The study included 52 women operated between 1985–2012. Obstetric hysterectomies were performed in 39 (75%) and 13 (25%) women, respectively. The results were statistically analyzed as arithmetic mean and standard deviation (SD).

Results: Peri- and postpartum hysterectomies accounted for 0.123% of all births (0.092% and 0.031%, respectively). Mean pa­tient age, length of pregnancy, and number of deliveries was 32.6 years [SD ± 6.2], 38.1 weeks [SD ± 7.0], and 3.2 [SD ± 2.4], respectively. In the study group, 92.31% of the women were multiparous, and 86.54% gave birth by cesarean section and had a history of CS. Placental pathology accounted for 44.4% of indications for hysterectomy. Blood transfusion was required in 94.2% of the cases, symptoms of hypovolemic shock were observed in 21.2%, and ICU admission was required in 15.4% of the patients. Relaparotomy was necessary in 4 (7.7%) cases. Intrauterine fetal death occurred in 4 (7.6%) cases and extremely poor neonatal status was observed in 4.1% of the newborns.

Conclusions: Hemorrhage due to placental pathology was the most frequent indication for obstetric hysterectomy. Risk factors for obstetric hysterectomy included multiparity, history of CS, recent CS, and age > 35 years. Postpartum hysterec­tomy accounted for 25% of the obstetric surgeries.