RETROSPECTIVE 6 YEARS STUDY OF MATERNAL OUTCOME AFTER CAESAREAN HYSTERECTOMY IN SULAIMANI MATERNITY TEACHING HOSPITAL

Chro Najmaddin Fattah a and Shanyar Mohamed b



a Department of Gynecology and Obstetrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
b Kurdistan Board Medical Studies Candidate.


Submitted: 1/17/2018; Accepted: 21/10/2018; Published 21/6/2019

ABSTRACT


Background 

Caesarean hysterectomy is one of the surgical procedures that performed as a last choice for saving mothers life challenging all obstetricians about the exact management between saving life or saving the fertility with the available resources. 


Objectives 

This study was conducted to determine incidence, associated factors and maternal morbidity and mortality after cesarean hysterectomy.

Patients and Methods

It is a descriptive retrospective study conducted over 6 years from 2012 to 2017 included all caesarean (peripartum) hysterectomies performed in Sulaimani maternity teaching hospital beyond 24 week gestation. File records was used to determine the data regarding the research. We used “IBM SPSS Statistics version 20” for the analysis of the data.


Results

The prevalence of cesarean hysterectomy was 0.56/1000 total deliveries. The ages were between 35-40 years, risk factors of last pregnancy were obesity, grand multiparity, and previous C\S were found in 55%, 65%, and 65% respectively. For antepartum and intrapartum risk factor antepartum hemorrhage and postpartum hemorrhage represented 20% and 30% respectively. Most of their pervious pregnancies delivered by (C/S) and 20% had history of 3 previous C/S, and 25% their pregnancy was complicated by gestational diabetes mellitus. Regarding intraoperative management blood product, B- Lynch suture, internal iliac artery ligation, intrauterine balloon, and recombinant factor 7 used in almost all cases. In follow up cases for 1 year chronic pelvic pain was most frequent complaint in 20% and ovarian cyst was also found in about 25%. 


Conclusion

Prevalence of cesarean hysterectomy incidence was 0.56/1000 total deliveries. The significant risk factors were obesity, grand multiparity, and history of previous C\S sections. Regarding maternal age is not far from the international age related to cesarean hysterectomy.



KEYWORDS

Caesarean hysterectomy, Postpartum hemorrhage, Antepartum hemorrhage, Placenta previa, lacenta accreta/increta, multiparity.