Objective: This study aimed to evaluate and compare maternal outcomes following emergency and elective hysterectomy performed during or after delivery at Hanoi Obstetrics and Gynecology Hospital over a five-year period (2019–2023).
Materials and method: This retrospective study comparing two surgical groups included 276 patients who underwent hysterectomy during or after delivery at Hanoi Obstetrics and Gynecology Hospital between January 1, 2019, and December 31, 2023.
Results: Subtotal hysterectomy accounted for 97.1%. Preservation of both adnexa was observed in 98.9% of cases. The mean blood loss was 1803 ±1205 ml, and the average blood transfusion was 2216 ±2285 ml, higher in the emergency hysterectomy group compared to the elective hysterectomy group (2215 ml vs. 1617 ml) (p < 0.001). The rate of intraoperative and postoperative complications was 28.6%, including bladder and ureter injuries (14.5%) and ICU admission (12.3%), mainly in cases of uterine atony and placenta accreta. The most common complications in the emergency hysterectomy group were ICU admission and bleeding requiring reoperation, while the only complication in the elective hysterectomy group was bladder and ureter injury. The surgery duration was slightly shorter in the elective hysterectomy group compared to the emergency hysterectomy group (86.1 minutes vs. 92.7 minutes) (p = 0.33).
Conclusion: Blood loss and transfusion requirements were significantly higher in the emergency hysterectomy group compared to the elective hysterectomy group. Common complications in elective hysterectomy included bladder and ureter injuries, while in emergency hysterectomy, common complications included reoperation due to intra-abdominal bleeding and ICU treatment. Surgery duration did not differ significantly between the two groups