A three year audit of emergency peri-partum hysterectomy at Lady Willingdon hospital Lahore

Objective: the objective was to know the incidence,indications and outcome of emergency peri-partum hysterectomy study design: this study was a descriptive case series study. the study period was three years with effect from 01-01-2008 to 31-12-2010. it was conducted in lady willingdon hospital lahore. study design:-descriptive case series. setting: department of obstetrics & gynaecology,lady willingdon hospital lahore. duration of study: three years with effect from 01-01-2008 to 31-12-2010 sample size:-190 patients who underwent emergency peri partum hysterectomy out of 67368 total deliveries in the 3 year study period. sampling technique:-non probability: convenience sampling. results: 190 patients underwent emergency peri-partum hysterectomy out of 67368 deliveries in the study period. (incidence 0.28 %) caesarean hysterectomy was performed in 0.54% of patients (n 119) (total c sections 21889) and an emergency hysterectomy following a vaginal delivery was done in 0.15% cases (n 71) (total vaginal deliveries 45479). uterine atony,placenta praevia and placenta accreta were the leading indications for peri-partum hysterectomy. a subtotal hysterectomy was performed in 30 cases. there were 20 maternal deaths. conclusion: grand multi-parity leading to uterine atony and repeat caesarean section leading to abnormal placentation were found to be the major risk factors for emergency peri-partum hysterectomy. although the procedure is associated with serious morbidity & mortality,but still it is life saving as we were able to avoid 154 potential maternal deaths with the procedure.