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Abstract
Objective: To determine the complications in patients undergoing Emergency Obstetric Hysterectomy patients in Karachi.
Material and Methods: Cross-sectional study was carried out from 13th October 2024 to 13th April 2025 at the tertiary care hospital in Karachi. Women aged 18-49 years who underwent emergency obstetric hysterectomy were included through non-random consecutive sampling technique. Sample size of 191 was calculated using online open-epi sample size calculator using anticipated frequency of mortality at 14.4%, confidence level at 95% and margin of error at 5%. Patients we inquired about their socio-demographic and clinical details. Data related to procedural indications and post-surgical complications were recorded.
Results: Placenta Accreta Spectrum (39.8%) and uterine rupture (35.6%) were observed as the primary indications for EOH. Whereas, the women in this study suffered substantial morbidity, including AKI (25.7%), sepsis (20.0%), and DIC (15.7%). The overall mortality rate was 3.1%. Massive blood transfusion (aOR 4.25) and pre-existing hypertension (aOR 2.81) are the independent predictors for AKI. Moreover, co-morbidities including obesity (aOR 3.05) and diabetes (aOR 2.88), were found as the independent predictors for sepsis. Furthermore, the development of DIC was the most powerful independent predictor of mortality (aOR 18.5, p=0.009)
Conclusion: The study concludes that uterine rupture and accreta are the main indications for EOH. Blood transfusion along with hypertension serves as the major cause for AKI development. DIC is developed as the direct consequence of uterine rupture with severe blood loss.