A 27-year review of obstetric hysterectomy.

A retrospective case-review of 52 mothers who had a peripartum hysterectomy over the past 27 years was conducted at the Rotunda hospital, Dublin, Ireland. The chief indications were uncontrollable haemorrhage due to rupture of the uterus, placenta praevia and uterine atony. Obstetric hysterectomy is a formidable operation, usually performed as a life-saving measure and requires expert surgical dexterity in order to minimise the significant morbidity. The benefits of the subtotal operation appear to be superior to those of total hysterectomy. Counselling patients having a caesarean section regarding the possibility of hysterectomy is advisable in those who have had previous uterine surgery, multiple caesarean sections or placenta praevia.