Peripartum Hysterectomy: Incidence, Indications and Maternal Outcomes - A Prospective Study from South India

Dr. S. Priyanga, Dr. N. Anusuiya

Abstract: Background: Emergency peripartum hysterectomy (EPH) is a life-saving procedure performed to control intractable obstetric hemorrhage. The incidence and indications have evolved over time, necessitating contemporary analysis. Objective: To analyze the incidence, risk factors, indications, and fetomaternal outcomes of peripartum hysterectomy at a tertiary care hospital in South India. Methods: A prospective observational study was conducted at Government Raja Mirasudhar Hospital, Thanjavur for a period of 12 months. All cases of peripartum hysterectomy were analyzed for demographic characteristics, indications, risk factors, surgical details, and maternal and neonatal outcomes. Results: Among 18,527 deliveries, 46 peripartum hysterectomies were performed, yielding an incidence of 2.5 per 1,000 deliveries (0.2%). The incidence was higher following cesarean section (4.8/1000) compared to vaginal delivery (0.7/1000). The majority of women (71.7%) were aged 25-34 years, and 89.1% were multiparous. Abnormally invasive placenta was the leading indication (60.9%), followed by intractable atonic postpartum hemorrhage (32.6%). Major risk factors included multiparity (89.1%), previous cesarean sections (82.9%), and placenta previa (60.9%). Maternal complications included coagulopathy (28.3%), febrile episodes (26.1%), and acute kidney injury (23.9%). Maternal mortality was 4.3%, and perinatal mortality was 12.8%. Conclusion: The incidence of peripartum hysterectomy remains significant, with abnormally invasive placenta being the predominant indication. Previous cesarean sections emerged as a major risk factor, highlighting the importance of judicious use of primary cesarean delivery.

Keywords: Peripartum hysterectomy, postpartum hemorrhage, placenta accreta, cesarean section, maternal mortality

How to Cite?: Dr. S. Priyanga, Dr. N. Anusuiya, "Peripartum Hysterectomy: Incidence, Indications and Maternal Outcomes - A Prospective Study from South India", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 171-173, https://www.ijsr.net/getabstract.php?paperid=MR26203023936, DOI: https://dx.doi.org/10.21275/MR26203023936