Abstract
Objective: To determine the frequency, indications, types and outcomes of emergency obstetric
hysterectomy.
Material and Method: This retrospective review was undertaken in the Department of obstetrics
and Gynecology Unit III of Civil Hospital Karachi from July 2002 to December 2007. Data
regarding frequency of hysterectomy, maternal age, parity, causes of hemorrhage, type of
hysterectomy and its complications, was retrieved from yearly maintained Registers / proformas
of obstetrical hysterectomy and analyzed by computer software, SPSS version 13.
Results: Total number of deliveries during the study period was 10,127 and 69 emergency
obstetric hysterectomies were undertaken; frequency being 0.68% (1 in 150 deliveries). Only
2
16% of women were booked. The three most common causes were ruptured uterus in 24 women
(35%), uterine atony in 16 women (23%) and morbidly adherent placenta in 14 women (20%).
Total hysterectomy was undertaken in 65% of women and subtotal in 35%. Thirteen women
died; with mortality of 19%. Morbidity related to type of hysterectomy was not significantly
different except for risk of salpingo-oophorectomy (20% for total compared to 12.5% for
subtotal)
Conclusion: Emergency obstetric hysterectomy, although a frequent life saving operation, was
associated with significant maternal mortality, mostly due to the effects of massive hemorrhage.
The most frequent indication was ruptured uterus followed by uterine atony and morbidly
adherent placenta. (Rawal Med J 2009;34:75-78)

Key words: Emergency obstetric hysterectomy, Peripartum hysterectomy, postpartum hemorrhage.