Abstract

Post-partum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Emergency obstetric hysterectomy (EOH) is a life-saving procedure performed in cases of severe PPH unresponsive to conservative management. Aim and Objectives: The goals of this study were (1) to analyze the outcomes of EOH for life-threatening PPH performed over 12 months, (2) to investigate the causes of EOH, and (3) to assess the efficacy and safety of subtotal hysterectomy for PPH. Materials and Methods: Information on all hysterectomies conducted in the name of emergency obstetrics at Shyam Shah Medical College in Rewa, Madhya Pradesh, from January 2020 to December 2020. Coagulation function parameters, perinatal problems, and hysterectomy incidence and outcomes were studied. Results: Twenty-five women underwent an emergency hysterectomy. Twenty-five patients had a total hysterectomy, while the remaining 10 had a subtotal hysterectomy. When comparing the rates of total hysterectomy (TH) and subtotal hysterectomy (STH), women who had a cesarean section (CS) in the past had a statistically significant increase in the former (P = 0.004). There were no discernible differences in the surgical measures taken to avoid hysterectomy between the TH and STH groups. Reduced prothrombin activity (50%), placenta accreta, prior uterine curettage, uterine atony, grand multiparity (>6 pregnancies), and uterine rupture were identified as risk factors for the need for EOH in the treatment of PPH. In addition, the TH group experienced a more significant average blood loss than the STH group (6832±787 mL vs. 6329±893 mL, respectively; P =0.003). The overall rate of illness was 43.75 percent. Disseminated intravascular coagulation (DIC; n = 6, 32.5%) was the most prevalent complication. There were no statistically significant differences between the STH and TH procedures in terms of the occurrence of maternal problems.

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