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Wani RV, Abu-Hudra NM, Al-Tahir SI. Emergency peripartum hysterectomy: a 13-year review at a tertiary center in kuwait. J Obstet Gynaecol India. 2014;64(6):403-8doi: 10.1007/s13224-014-0554-z.
Wani, R. V., Abu-Hudra, N. M., & Al-Tahir, S. I. (2014). Emergency peripartum hysterectomy: a 13-year review at a tertiary center in kuwait. Journal of obstetrics and gynaecology of India, 64(6), 403-8. https://doi.org/10.1007/s13224-014-0554-z
Wani, Ramadevi V, et al. "Emergency peripartum hysterectomy: a 13-year review at a tertiary center in kuwait." Journal of obstetrics and gynaecology of India vol. 64,6 (2014): 403-8. doi: https://doi.org/10.1007/s13224-014-0554-z
Wani RV, Abu-Hudra NM, Al-Tahir SI. Emergency peripartum hysterectomy: a 13-year review at a tertiary center in kuwait. J Obstet Gynaecol India. 2014 Dec;64(6):403-8. doi: 10.1007/s13224-014-0554-z. Epub 2014 May 17. PMID: 25489143; PMCID: PMC4257923.
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J Obstet Gynaecol India. 2014 Dec;64(6):403-8. doi: 10.1007/s13224-014-0554-z. Epub 2014 May 17.

Emergency peripartum hysterectomy: a 13-year review at a tertiary center in kuwait.

Journal of obstetrics and gynaecology of India

Ramadevi V Wani, Nasra M S Abu-Hudra, Sami Ibrahim Al-Tahir

Affiliations

  1. Department of Obstetrics and Gynecology, Al-Jahra Hospital, Jahra, Kuwait ; PO BOX -17672, 72457 Khaldiya, Kuwait.
  2. Department of Obstetrics and Gynecology, Al-Jahra Hospital, Jahra, Kuwait.

PMID: 25489143 PMCID: PMC4257923 DOI: 10.1007/s13224-014-0554-z

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: Abnormal placentation; Cesarean delivery; Emergency peripartum hysterectomy; Previous cesarean section

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