Emergency hysterectomy in obstetrics: review of 15 years.

A total of 140 patients underwent emergency obstetric hysterectomy at Smt Sucheta Kriplani Hospital, New Delhi, India, over a 15-year period between 1976 to 1990. Rupture of uterus and obstetric hemorrhage were two major indications for obstetric hysterectomy. Maternal mortality occurred in 18 i.e. 12.8% of the cases. Hemorrhage was leading cause of maternal death. While major degree of placenta praevia was responsible for 39.3% of obstetric hemorrhage, it contributed to nearly 40% of maternal deaths. Fifty percent of placenta praevia cases had morbid adhesions of placenta, associated with previous cesarean section. Hence patients of previous cesarean section with placenta praevia should be operated by experienced obstetricians keeping plenty of blood ready.