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Changing Trends of Obstetric Hysterectomy Over Last 2 Decades: A Retrospective Analysis from a Single Center Tertiary Care Rural Teaching Hospital of Western India

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Abstract

Objective

The primary objective of our study to analyze the trend of obstetric hysterectomy (OH) over last 2 decade in rural tertiary care referral center of western India.

Design

Retrospective observational and comparative study from single rural tertiary care referral center of western India.

Method

A retrospective data collected of patients who underwent OH from Jan 2001 to Dec 2021. Each patient studied in detail for demographic and clinical profile, indication of OH, Intra operative and post operative complication and feto-maternal outcome. Patient of first decade (2001 to 2010) compared with second decade (2011 to 2021) to see the changing trend of OH.

Results

Total 19,666 patients delivered in study period.195 patient underwent OH. Incidence of OH is 0.9%. 171 out of 195 patients were referred (87%). If we see the trend of OH over 2 decades 2001 to 2010 and 2011 to 2021 incidence of OH slightly raised from 0.87% to 1.07% (p 0.16). Although Incidence of OH in cesarean delivery rises from 0.6 to 1.4% (p 0.6) but this change due to overall increase in cesarean section rate from 37 to 49%(p < 0.0001). Indication of OH significantly change as uterine rupture decrease significantly from 61 to 22%(p < 0.001) and morbidly adherent placenta increases from 7 to 23%(p 0.007). ICU admission and ventilator support increases from 54 to 79%(p 0.04) and 22% to 70% (p < 0.001), respectively, due to improved critical care services, but maternal death remains relatively same 15% & 20% (p 0.5).

Conclusion

Primary CS rates should be decreased to prevent adherent placenta spectrum disorders. Good antenatal care and development of a robust referral system can decrease maternal mortality. Greater utilization of skill laboratory and simulators will go a long way in developing the skills of aspiring doctors in operative vaginal deliveries.

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Funding

This study not funded by any authority.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Shree Krishna Hospital and Pramukh Swami Medical College, Anand-Sojitra Road, Karamsad, Anand, Gujarat, PIN: 388325, India

    Vishal Sheth, Smruti Vaishnav, Shilpa Sapre, Rumi Bhattacharjee, Nitin Raithatha & Manisha Asrani

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  1. Vishal Sheth
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  2. Smruti Vaishnav
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  3. Shilpa Sapre
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  4. Rumi Bhattacharjee
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  5. Nitin Raithatha
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  6. Manisha Asrani
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Corresponding author

Correspondence to Vishal Sheth.

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Conflict of interest

All authors undersigned declare that they have no any conflict of interest.

Ethical approval

This article does not contain any animal studies. Ethical approval taken from HREC committee of institution before conducting this study. All authors declare that this article not under consideration for publication anywhere.

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Written informed consent taken from all patients included in our study.

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Vishal Sheth is a Associate professor; Smruti Vaishnav is a professor and head; Shilpa Sapre is a professor; Rumi Bhattacharjee is a professor; Nitin Raithatha is an professor and Manisha Asrani is an Intern.

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Sheth, V., Vaishnav, S., Sapre, S. et al. Changing Trends of Obstetric Hysterectomy Over Last 2 Decades: A Retrospective Analysis from a Single Center Tertiary Care Rural Teaching Hospital of Western India. J Obstet Gynecol India 73 (Suppl 2), 206–212 (2023). https://doi.org/10.1007/s13224-023-01842-z

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  • DOI: https://doi.org/10.1007/s13224-023-01842-z

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