Epidemiological correlates of hysterectomy, a hospital based study 1995 -1996 at Ain Shams Maternity Hospital

Hysterectomy is one of the most frequently performed major surgical procedures for women. Study the epidemiological correlates of hysterectomy and identify the different indications that lead to the operation as well as determine its frequency. SUBJECTS AND METHODS: A retrospective study was performed which included 231 women who had undergone hysterectomy during 1995-1996. Data about the various characteristics of women, indication, and type of surgery were retrieved from the medical fles of women in Ain Shams Maternity Hospital. RESULTS: The hospital incidence rate of hysterectomy during 1995-1996 was 9.8/1000 admission, while it rose to 13.8/1000 in the year 2000 (recent data from hospital statistics unit) Epidemiological data showed that the mean age of women was 45.4+/-8.9, the highest frequency of hysterectomy was in the age group 45-54 years (41.2%). Hysterectomy in those aged less than 35 years was 7.3%. Previous abortion accounted for 48.5% early age at menarche (< or =12) was 13%, multiparity (> or =5) was 54.4%. Among women aged less than 35 years, uterine leiomyoma was the commonest indication (29.4%), while dysfunctional uterine bleeding was the commonest indication among those aged 35-<45, and 45-<55 and accounted for 40.6% and 60% respectively. Those aged > or =55 years, uterine prolapse was the commonest indication (53.6%). Malignant neoplasm covered less than 5% of all hysterectomies. Among nullipara, uterine leiomyoma was the most frequent indication (66.7%), while among parous women, dysfunctional uterine bleeding was the most frequent (56%). The most common obstetric indication leading to hysterectomy was uncontrolled postpartum hemorrhage and ruptured uterus (57.2%) of all obstetric causes. The abdominal route was the commonest approach for hysterectomy (54.1%), followed by the vaginal (35.9%). CONCLUSION AND RECOMMENDATIONS: Hysterectomy rate in Ain Shams Maternity hospital showed a significant increase by the year 2000 than during the period of the study. Further studies are needed to identify the reasons for such increase and to reduce unnecessary operations. The present study draws the attention of the importance of prenatal care for early detection of high risk women, and prevent complications of bleeding specially in women under 35 years who may not have completed their families and who may prefer other alternatives to surgery.