Emergency obstetrical hysterectomy among post-partum hemorrhage women in Larkana

Abstract

Postpartum hemorrhage (PPH), is an excessive bleeding after giving birth, it is a major cause of maternal mortality and morbidity around the world. In the current era of obstetrics, emergency obstetric hysterectomy (EOH) is still a crucial treatment that can save lives. This study was designed to determine causes, frequency, complications of emergency cesarean /obstetrical hysterectomy in Postpartum hemorrhage (PPH) in tertiary care hospital. All the patients gave birth during 4 years (i.e. 1January 2020- 31 December 2023) were included in this study. The obstetrical patients admitted were 13532, out of which 154 underwent emergency hysterectomy. Their biodata, sign and symptoms, diagnosis, fluid/blood transfusion, morbidity, operative intervention, maternal mortality, and follow up were taken on a proforma. The data thus taken was compiled and analyzed. The incidence of EOH was 11.4/1000 obstetrical cases, mostly (85.5%) were referral from elsewhere, while 20 (13.79%) were registered as booked who took proper antenatal care. Multipara (94%) was predominantly reported with post-partum hemorrhage (n=79, 51.29%). The maternal mortality was 15.59% (n= 19). Regular and scheduled antenatal care, early diagnosis, early referral, timely decision, blood transfusion with arrangement of surgery by an experienced obstetrician are crucial to justify EOH.