Open Journal of Obstetrics and Gynecology, 2017, 7, 258-268
http://www.scirp.org/journal/ojog
ISSN Online: 2160-8806
ISSN Print: 2160-8792
DOI: 10.4236/ojog.2017.72028 February 28, 2017
Peripartum Hysterectomy in Misan Province
during 2014-2016
Saba J. Al Heshemi
Department of Gynecology & Obstetrics in College of Medicine, College of Medicine, Misan University, Misan, Iraq
Abstract
Background: Peripartum hysterectomy is the procedure of removing the ute-
rus after vaginal delivery or cesarean birth; it remains a life-saving procedure
in cases of severe uterine hemorrhage. Objective: To know the incidence of
peripartum hysterectomy in Misan province, what is the main cause of this
procedure, and if there is any change in the incidence of this procedure during
a 3 year study period. Method: A descriptive cross sectional study was done in
Misan province for all cases of peripartum hysterectomy during the period
from 2014-2016. All information regarding present pregnancy, previous ob-
stetric history, the cause of peripartum hysterectomy, any complications &
infant outcome, were taken from the case sheet & from the patients them-
selves. 50 patients were enrolled in this study, and only 30 patients needed pe-
ripartum hysterectomy and 20 patients’ uterus were saved by repair surgery.
Results: During the study period of 3 years, there was 72,720 deliveries, and
during that time 30 peripartum hysterectomies were carried out of the 50 cas-
es studied, which gave an incidence of 0.4/1000 deliveries. The patients were
diagnosed as: rupture uterus in 30 (60%) cases, adherent placenta in 14 (28%)
& 6 (12%) cases had atonic uterus. The major postoperative complication was
anemia which complicated 23 (46%) cases, & then bladder injury 5 (10%).
Admission to ICU was needed for 24 (48%) cases. There were 32 (64%) cases
needed ≥4 units of blood transfusion. There were 38 (76%) cases stayed in
hospital for ≥4 days. The most common cause for peripartum hysterectomy
was for adherent placenta (28%) & rupture uterus (20%). Conclusion: The in-
cidence of peripartum hysterectomy was 0.4/1000 (0.04%) deliveries. The most
common reason behind peripartum hysterectomy was for adherent placenta
and next was for uterine rupture. The rate of this procedure was not changed
during the study period.
Keywords
Peripartum Hysterectomy, Primary Postpartum Hemorrhage, Rupture
Uterus, Adherent Placenta
How to cite this paper: Al Heshemi, S.J.
(2017) Peripartum Hysterectomy in Misan
Province during 2014-2016. Open Journal
of Obstetrics and Gynecology, 7, 258-268.
https://doi.org/10.4236/ojog.2017.72028
Received: January 9, 2017
Accepted: February 25, 2017
Published: February 28, 2017
Copyright © 2017 by author and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access