Emergency obstetric hysterectomy in Qatar--a 20-year review.
OBJECTIVE
To determine the incidence, indications, and predisposing factors for emergency hysterectomy in Qatar.


METHODS
Retrospective chart review between January 1979 and December 1997 to determine the total number of emergency hysterectomies performed. We reviewed the case notes for all the patients (only 10 were not available).


RESULTS
Of 17,535 deliveries, emergency hysterectomy was performed in 64 patients (0.04%). The indications were persistent bleeding from placenta previa in 19 patients (35%), ruptured uterus in 16 patients (29.6%), placenta accreta in 12 patients (22.2%), and atonic uterus in 7 patients (13.0%). Total abdominal hysterectomy was performed in 21 cases (38.9%), and subtotal hysterectomy was performed in 33 cases (61.1%). There were 3 maternal deaths (5.5%) due to severe bleeding.


CONCLUSIONS
Even though emergency hysterectomy was rare in our study, the presence of an experienced obstetrician is important in high-risk patients to make an early decision to operate before the patient's condition deteriorates and to provide the technical skills required to minimize morbidity and mortality.
Hamsho
M A
MA
Department of Obstetrics and Gynaecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar.
Alsakka
M
M
D000328:Adult; D017677:Age Distribution; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality* / Q000706:statistics & numerical data*; D015994:Incidence; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011780:Qatar / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors