Original Article

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Abstract

Background: The prevalence of caesarean sections is escalating globally, instigating a consequential rise in mortality and morbidity rates. Among the various ensuing complications, postpartum haemorrhage (PPH) represents a significant risk that necessitates immediate intervention, as failure to address this could escalate to the necessity of a caesarean hysterectomy (CH).

Objective: To identify the risk factors, indications, and outcomes of caesarean hysterectomies performed at Liaquat University Hospital in Hyderabad.

Methodology: This descriptive, cross-sectional analysis incorporated a sample of 125 pregnant women selected through non-probability, consecutive sampling. All participants were scheduled for an emergency caesarean hysterectomy either immediately or within 24 hours post-caesarean delivery at the same facility. After acquiring written informed consent, information pertaining to demographics, presenting complaints, gestational specifics, and data about indications, risk factors, and outcomes related to cesarean hysterectomy were recorded through a structured questionnaire. Data analysis was conducted using SPSS software, version 21.0.

Results: The average gestational age was reported as 37 weeks (± 1.5 SD) and the average maternal

age was 24 years (± 3 SD). The proportion of registered to non-registered cases was approximately 8:1. Of the 109 patients with complications or unfavorable maternal outcomes, the most prevalent was an extended hospital stay (21.6%). The need for Intensive Care Unit admission (19.2%), bladder injuries (16.8%), and mortality (15.2%) were other significant adverse outcomes. Less frequently noted complications included acute renal failure (4.8%), wound infection (7.2%), disseminated intravascular coagulation (3.2%), acute respiratory distress syndrome (ARDS), and pulmonary embolism (4.8%).

Conclusion: Our findings suggest that CH is not uncommon and is often associated with distressing maternal outcomes. Factors such as parity, patient registration status, and placenta previa were found to predispose women to CH. Furthermore, CH showed a significant correlation with poor maternal outcomes.

Keywords: Caesarean Hysterectomy, Post-Partum Haemorrhage, Parity, Placenta Previa, Wound Infection.