Obstetric hysterectomy: Ramathibodi's experience 1969-1987

Obstetric hysterectomy was performed on 121 women at Ramathibodi Hospital, Bangkok, between 1969 and 1987, an incidence of 1:875 deliveries. Of 88 women whose records were available, 91% had emergency hysterectomy, with uterine atony as the most common indication (32.5%), followed by placenta accreta (26.2%), uterine rupture (10.0%), extension of cervical tear to the lower uterine segment (8.7%), broad ligament hematoma (6.2%) and placenta previa (5.0%). The intraoperative and postoperative problems included febrile morbidity (52%), intraoperative hypotension (41%), and disseminated intravascular coagulation (5.7%). Late complications included Sheehan's syndrome (3.4%), post-transfusion hepatitis (2.3%), hematoma (2.3%) and wound infection (2.3%).