Introduction: Emergency hysterectomy is the surgical removal of the uterus following an unexpected and sudden event, which must be dealt with urgently by carrying out the procedure. When it is carried out in a woman with a pregnant uterus less than 24 hours after delivery, it is termed emergency peripartum hysterectomy. Peripartum Hysterectomy is an essential part of the obstetricians armamentarium. On one hand, it is the last resort to save a woman's life and on the other hand, her reproductive capability is sacrificed. Many times it is a very difficult decision and requires good clinical judgment.
Objectives: To evaluate the indications, outcome and complications associated with peripartum hysterectomy procedures.
Methods: A retrospective study of all cases of caesarean and postpartum hysterectomy between July 2019 and December 2020. Maternal characteristics, indications for hysterectomy and complications were reviewed.
Results: The rate of peripartum hysterectomy was 1.32:1000 deliveries. Most were operative deliveries. The main indications were placenta accrete (36%), massive atonic PPH (32%) and uterine rupture (18%). Maternal morbidity was high and there were four maternal deaths (8%). All deaths were in patients brought in a critical condition to the hospital after massive blood loss.
Conclusion: Peripartum hysterectomy is potentially a life saving procedure but the mortality and morbidity is high, especially if performed late when the hemodynamic instability has already set in.