Frequency of various factors leading to peripartum hysterectomy.

Abstract

Objective: To determine the frequency of common causes of peripartum hysterectomy and to evaluate their association with demographic and clinical variables among women managed at a tertiary care hospital. Study Design: Descriptive Cross-sectional study. Setting: Department of Obstetrics and Gynecology, Sialkot Medical College and its Affiliated Hospitals. Period: September 2025 to March 2026. Methods: After approval from the Institutional Review Board of Sialkot Medical College (IRB No. SMC-IRB/03/25 dated 21st January 2025), this descriptive cross-sectional study was conducted on 100 patients undergoing peripartum hysterectomy who were included through non-probability consecutive sampling. Data were collected using a predesigned proforma that included demographic variables such as age, body mass index (BMI), mode of delivery, and socioeconomic status, along with clinical variables including obstructed labour, previous cesarean section, grand multiparity, prolonged labour, placenta previa, and uterine atony. Data analysis was performed using SPSS version 22.0. Quantitative variables were expressed as mean ± standard deviation, while qualitative variables were presented as frequencies and percentages. Stratification and post-stratification Chi-square tests were applied, and a p-value ≤0.05 was considered statistically significant. Results: The mean age of the patients was 29.52 ± 4.40 years, while the mean BMI was 24.91 ± 2.82 kg/m². Cesarean section was the most common mode of delivery (58%), and the majority of patients belonged to the low socioeconomic group (63%). The most frequent risk factor associated with peripartum hysterectomy was previous cesarean section (74%), followed by grand multiparity (46%), uterine atony (45%), obstructed labour (35%), placenta previa (25%), and prolonged labour (18%). Stratified analysis demonstrated no statistically significant association of these risk factors with age, BMI, mode of delivery, or socioeconomic status (p > 0.05). Conclusion: Previous cesarean section, grand multiparity, and uterine atony were the most common factors associated with peripartum hysterectomy. The high prevalence of these potentially preventable risk factors highlights the importance of reducing unnecessary cesarean sections, improving antenatal risk assessment, and ensuring timely obstetric management to decrease maternal morbidity and improve outcomes.