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The Journal of Obstetrics and Gynecology of India

, Volume 64, Issue 6, pp 403–408 | Cite as

Emergency Peripartum Hysterectomy: A 13-Year Review at a Tertiary Center in Kuwait

  • Ramadevi V. WaniEmail author
  • Nasra M. S. Abu-Hudra
  • Sami Ibrahim Al-Tahir
Original Article

Abstract

Objective

To determine the incidence, indications, risk factors, and complications of emergency peripartum hysterectomy (EPH) and to evaluate total versus subtotal hysterectomy for EPH.

Materials and Methods

This is a retrospective case series involving thorough examination of the files of all women who had EPH between January 2000 and December 2012 in the department of Obstetrics and Gynecology, Al-Jahra hospital, Kuwait after taking approval from the ethics committee. Incidence, indications, risk factors, type of hysterectomy, and complications of EPH were obtained from patient files.

Results

There were 63,337 deliveries of which 70.3 % were vaginal deliveries, and 29.6 % were by cesarean section (CS). Sixty-eight women underwent EPH representing an overall incidence of 1 case per 1,000 deliveries. The indications for EPH included abnormal placentation (77.4 %), uterine atony (14.5 %), and uterine rupture (8.1 %). There was one maternal death. Maternal morbidity occurred in 25 (40.3 %) women. The most common complications were mild to severe coagulopathy (19.35 %) and injury to the urinary tract (17.74 %). Injury to the ureter was avoided by placing ureteric stents preoperatively. Our population was significant in having higher rate of CS deliveries (91.9 %), women with prior CS (83.87 %), and high parity (mean 5.8).

Conclusion

Abnormal placentation was the most common indication to perform EPH. The relative risk of EPH was 27 for CS deliveries as compared to vaginal deliveries. There was no significant difference between subtotal versus total hysterectomy with respect to age, parity, previous CS, operative time, blood transfusion, and intra and post operative complications.

Keywords

Emergency peripartum hysterectomy Abnormal placentation Previous cesarean section Cesarean delivery 

Abbreviations

EPH

Emergency peripartum hysterectomy

CS

Cesarean section

Notes

Funding

We have not received any financial assistance or funds for this study.

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Copyright information

© Federation of Obstetric & Gynecological Societies of India 2014

Authors and Affiliations

  • Ramadevi V. Wani
    • 1
    • 2
    Email author
  • Nasra M. S. Abu-Hudra
    • 1
  • Sami Ibrahim Al-Tahir
    • 1
  1. 1.Department of Obstetrics and GynecologyAl-Jahra HospitalJahraKuwait
  2. 2.KhaldiyaKuwait

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