Emergency peripartum hysterectomy at the Princess Badeea Teaching Hospital in north Jordan.

OBJECTIVE

To study the prevalence, indications and outcome of emergency peripartum hysterectomy in women delivered at the Princess Badeea Teaching Hospital in North Jordan.

METHOD

This is a retrospective study of all cases of emergency peripartum hysterectomy performed between 1st of January 1994 and 31 August 1998.

RESULTS

During the study period there were a total of 21 emergency peripartum hysterectomy were performed. The overall incidence was 0.5/1,000 deliveries. The mean age of patients was 34.7 +/- 3.9 years, the median parity was 6 and the mean gestational age was 36.9 +/- 2.01 weeks. There were 19 cases of caesarean hysterectomy. The leading indication for caesarean section was previous caesarean section (89.5%), placenta previa alone (10.5%). It should be noted that 7 cases with previous caesarean section also had placenta previa (41.2%). The main indications for emergency hysterectomy were, abnormally adherent placenta was the leading indication (38.1%), followed by rupture uterus (33.3%), haemorrhage and uterine atony occurred in 14.3% of cases each, maternal complications occurred in 42.9% of cases postoperatively. There were 4 cases of stillbirths and 2 cases of neonatal deaths.

CONCLUSION

Peripartum hysterectomy remains a necessary procedure for life saving during abdominal and vaginal deliveries. The procedure itself is usually associated considerable perioperative morbidity. Obstetricians should identify patients at risk and anticipate the procedure and complications.