Radical Vaginal Hysterectomy and Trachelectomy in Early-Stage Cervical Cancer

Objective: To communicate a minimally invasive technique for surgical handling of early-stage cervical cancer and its results. Methods: 110 patients with cervical cancer in stages IA2 and IB1, all of them operated in a period of 5 years in both hospitals, are presented. Laparoscopic systemic pelvic lymphadenectomy with radical vaginal hysterectomy or radical vaginal trachelectomy was performed to patients, with the exception of those patients who had compromised nodes detected in contemporary biopsy. Results: Between April 2008 and May 2013, 110 patients were submitted to this technique. 15 patients had their surgery aborted: 13 presented positive nodes for carcinoma in contemporary biopsy and 2 had extensive cervical compromise when performing radical vaginal hysterectomy or trachelectomy. Analysis of the remaining 95 cases shows an average age of 43.9 years (26 - 61), all of them had given birth before, 23 (21%) of them through C-section. BMI averaged 30.5 and 31 (28.2%) had cone surgery performed previously. Average duration of surgery was of 220 minutes. Postoperative hospitalization averaged 3.1 days. Bleeding volume was estimated at 125 cc and one patient required blood transfusion. En 25 patients’ uterine annexes were kept and all of them were suspended by means of laparoscopy. On average, 25.4 pelvic nodes were obtained. Complications 13.6% with eight patients suffered bladder injury, two had rectovaginal fistula, 3 patients requires surgical repair of ureteral obstruction, two patients present thromboembolic disease. The disease-free and overall survivals are consistent with reports in the literature. Conclusion: We believe that handling patients with this technique is possible and has the advantages of vaginal and laparoscopic surgery with minimal complications.

Vault Hematoma after Vaginal Hysterectomy: An Invariable Complication

Hysterectomy is common major operation performed in gynecological field practice after Caesarean section. Vaginal hysterectomy is preferred surgery for uterovaginal prolapsed. Vaginal hysterectomy has advantages over abdominal hysterectomy. Post hysterectomy hematomas are responsible for serious morbidity. Ultrasound is an accurate diagnostic tool and so Computed tomography. Conservative management, analgesia and antibiotics will work in small hematoma, but the significant sized hematoma needs surgical drainage and the infected hematoma. Refinement in surgical techniques is recommended to minimize the formation vaginal vault hematomas after vaginal hysterectomy.

Vaginal Robotic Supracervical Hysterectomy in an Ovine Animal Model: The Proof of Concept

Objective: To gain insight into the feasibility and safety of a novel vaginal robot for performing supracervical hysterectomy in an ovine model. Introduction: The clinical application of transvaginal natural or fice transluminal endoscopic surgery (vNOTES) has broadened significantly. vNOTES reduces wound complications such as infection, hematoma formation, or herniation and is currently utilized for hysterectomy, adnexal surgery, myomectomy, and staging surgery for endometrial cancer. Robotic assistance has been proposed to overcome the current vNOTES mechanical obstacles. The implementation of the current robots has limited utility due to their bulk and inflexibility. Robotic Natural Orifice Transluminal Surgery (rNOTES) is the new frontier in advancement of surgical robots. In developing new task specific robots, it is important to utilize an accurate model for testing. A novel vaginal robot introduced through the posterior cul-de-sac to perform a complete retrograde hysterectomy is the subject of this study. Methods: The study was conducted at the animal lab, Asaf-Harofe hospital, Israel. The ovine model was preferred since the anatomical landmarks and vascular anatomy are comparable to the human except for a bicornuate uterus in sheep. A vaginal robotic supra-cervical hysterectomy was performed in a sheep. Results: A vaginal robotic supracervical hysterectomy was performed successfully in an ovine model. The uterus was extracted via the entry point in the pouch of Douglas. 20 cc of blood loss was reported and no complications were observed. Conclusions: Vaginal supracervical hysterectomy via a vaginal approach using a novel robotic system was found to be feasible.

Small Bowel Evisceration Following Vaginal Hysterectomy is a General Surgical Emergency–A Case Report and Review of the Literature

Small bowel evisceration through the vagina is a rare condition, which tends to affect post-menopausal women who have undergone vaginal hysterectomy. It is a surgical emergency with a favourable outcome if diagnosed and treated in a timely fashion. Delay in diagnosis can precipitate infarction of small bowel loops with associated morbidity and mortality. Treatment involves laparotomy, reduction of the incarcerated loops (plus/minus small bowel resection) and repair of the vaginal rupture. The purpose of this paper is to report a case of small bowel evisceration through the vagina, to review the literature pertaining to this topic and to raise awareness of this condition in the general surgical community.

Vaginal Trachelectomy for Retained Cervical Stump after Supracervical Hysterectomy: Technical Tips and Outcomes

Background and Objectives: The supracervical hysterectomy (SCH) has resulted in a group of patients with a retained cervix at risk of persistent symptoms, who may require a trachelectomy in the future. This study was to evaluate the efficacy of vaginal trachelectomy (VT) after a previous SCH. Methods: This was a prospective study that includes 13 cases with different ages and different complaints, sharing the same primary operation supracervical hysterectomy. They have different pathologies of the SCH specimen but they share the same completion surgery. The surgical outcome was analyzed. Results: Thirteen patients underwent vaginal trachelectomy for recurrent symptoms. The ages of patients were ranged from 37 years to 68 years (Mean ± SD, 56.4 ± 10.7). SCH was most commonly performed for abnormal uterine bleeding AUB (7/13, 53.8%), pelvic mass (5/1, 38.5%), and pelvic pain (1/13, 7.7%), the symptoms leading to vaginal trachelectomy were the same as those leading to supracervical hysterectomy. The median interval time from SCH to seeking medical help for the persistence or recurrence of symptoms and to VT was 2 weeks (1 to 96 weeks). Concomitant procedures were laparoscopic removal of both ovaries in 2 cases and pelvic lymphadenectomy in 1 case. The median length of operation was 45 minutes. In all cases, symptoms leading to trachelectomy resolved completely after surgery, and patients reported a significant improvement. Conclusions: The cervix, left behind at subtotal hysterectomy, requires removal, the vaginal route is probably the safest, and least traumatic. Vaginal radical trachelectomy appears to be feasible and safe for the treatment of endometrial malignancy discovered after supracervical hysterectomy.

A Retrospective Review: Vaginal versus Abdominal Hysterectomy for Benign Gynecological Diseases in a Tertiary Canter

The aims are to review respectively 229 cases of hysterectomy and to find the factor affecting the decision of vaginal hysterectomy. Data collected from medical charts include age, nationality, parity, menopause, history of Dilation and curettage. The following data were obtained: the clinical presentation and the indication for hysterectomy. Postoperative complication includes the estimated blood loss, the number of days in hospital and ICU admission recorded. The route of hysterectomy found that 187 (82%) were abdominal and only 42 (18%) were vaginal. Factors significantly associated with the choice of vaginal approach: age, parity, smaller uterine size and prolapse. Factors affecting the decision of vaginal hysterectomy for treatment of benign diseases are identified as follows: if the age is more than 35 years or if the women already reach menopause, the presenting symptoms are not vaginal bleeding but prolapsed uterus and uterine size is less than 12 weeks.

Transvaginal natural orifice transluminal endoscopic surgery:A novel gasless technique to hysterectomy

Transvaginal natural orifice transluminal endoscopic surgery(vNOTES),as a minimally invasive surgery technique,applies CO_(2) for creating pneumoperitoneum,and uses a closed system to through smoke evacuation from a dedicated outlet or port.It has the potential to generate aerosol in the operation room,which can lead to an increased risk of transmission of SARS-CoV-2.This technical note introduces a new technique of gasless pure vNOTES to hysterectomy using silicone face mask as a modified vNOTES port.

VAGINAL HYSTERECTOMY FOR PATIENTS WITH MODERATELY ENLARGED UTERUS OF BENIGN LESIONS

Objective To evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. Methods One hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group Ⅰ contained 60 patients with uterine enlargement to a weight of 200 to 750 g, and group Ⅱ contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The peri-operative data in both groups were analyzed. Results In group Ⅰ, 59 cases underwent transvaginal hysterectomy successfully, except 1 case con-verted to abdominal operation and the uterine morcellation was performed in 21 women. In group Ⅱ, all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group Ⅰ was significantly heavier than that of group Ⅱ(280.18 ± 100.40 g vs 146.48 ± 35.19 g). The mean operating time was significantly longer for group Ⅰ than that for group Ⅱ(83.93 ± 26.26 minutes vs 35.22 ± 20.55 minutes). There were no significant differences in blood loss and complications between groupⅠ and group Ⅱ. There was no injury of urinary bladder or rectum, and no vaginal vault infection. Conclusions Vaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases, in order to reduce the uterine volume, uterine mor-cellation should be used to shorten operative time, reduce the bleeding, and lower the postoperative complications.

Vaginal hysterectomy or laparoscopic assisted vaginal hysterectomy for enlarged myomatous uterus:a randomized clinical trial

Objective:To compare the intraoperative condition and short-term outcomes of vaginal hysterectomy(VH) and laparoscopic assisted vaginal hysterectomy(LAVH) for enlarged myomatous uterus. Methods:Fifty patients from Peking Union Medical College Hospital(PUMCH) were randomly assigned to two treatment groups:VH(n= 23) and LAVH(n= 27).All procedures were performed by a single senior surgeon to maintain homogeneity. Results:The baseline characteristics of the two groups were comparable.The operative time for LAVH was significantly longer than for VH(76.7±23.2 vs.57.6±23.5 min,P<0.05),and LAVH costs more money than VH(6,923.07±622.96 vs.5,974.46±1,408.08 RMB,P<0.05).Major complications,uterine weight and the length of hospital stay were comparable between VH and LAVH group.One case of VH was converted to LAVH due to adhesion. Conclusions:Compared with LAVH,VH is a time- and cost-saving operative technique for enlarged myomatous uterus.VH should be the primary method for uterine removal,but LAVH may have advantages when adhesion is present.

Radical Hysterectomy in Cervical Cancer: Patients’ Epidemiological and Clinical Profiles and Perioperative Outcome in Two Referral Hospitals in Cameroon

Background: Cervical cancer (CC) is one of the most frequent cancers and the leading cause of death from gynecological cancer in Low and middle income countries, Cameroon inclusive. Surgery is the primary treatment modality when the disease is diagnosed at early stage. Radical hysterectomy in cervical cancer has not been evaluated in recent years in Cameroon. The purpose of this study is thus to evaluate the epidemiological and clinical features and short term outcomes of patients who underwent surgery. Patients and methods: This retrospective study was conducted at the Douala Gynaeco-obstetric and Pediatric Hospital and the Douala General Hospital. Cervical cancer patients who underwent Radical hysterectomy between January 2015 and December 2020 were included. A pre-established data collection tool was used to record socio-demographic, clinical and outcomes information from patients’ files;additional outcome information was obtained from phone calls. Descriptive analysis was done using the SPSS version 26. Bivariate analysis was used to determine associations between disease and patients characteristics and occurrence of adverse postoperative outcome. P value of 0.05 was considered. Results: Sixty one patients were enrolled. Their ages ranged from 33 to 74 years with a mean age of 51.95 ± 10.29 years. Over 85% of women were married, 65.57% were unemployed and 86.88% were multiparous. Only 28% had never done cervical cancer screening. Most patients had stage IB1 to IB2 stage disease (57.1%). Less than 9% underwent radical hysterectomy and 8 of those (13.11%) suffered intraoperative complications. Twenty-five patients (40.98%) presented immediate and short term complications. There was no significant association between the disease or patients’ characteristics and adverse outcomes. Conclusion: Cervical cancer patients are relatively young in our settings and only 9% of them reach the hospital at early stage. Postoperative adverse outcomes rate is higher than that reported in the literature. Sensitization on screening and awareness of early symptoms can reverse the situation.

Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.

Effects of β-Glucan Supplementation on Repairing of Phenol-Induced Vaginal Mucosal Epithelium Damage in Rats

Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.

Spontaneous Paravesical and Broad Ligament Hematoma after Vaginal Delivery Had Uterine Artery Embolization after Evacuating the Hematoma

Broad ligament hematoma is typically seen during cesarean section due to rupture of branches of uterine and vaginal vessels and it’s rare to be seen post-normal vaginal delivery. Addressing puerperal hematomas postpartum presents considerable challenges for obstetric care providers. While hematomas such as those affecting the vulva, vulvovaginal region, or paravaginal area are frequently encountered, retroperitoneal hematomas are rare and notably pose a greater risk to the life of the patient. The medical literature contains scant case reports on retroperitoneal hematomas, with no consensus on a definitive treatment approach. Pelvic arterial embolization has emerged as both a sensible and increasingly preferred method for treating these hematomas recently, but its application is contingent upon the patient maintaining hemodynamic stability and the availability of a specialized interventional embolization unit. In our case, we are presenting a very rare case of a 31-year-old primigravida female with a history of in vitro fertilization pregnancy. She delivered a normal vaginal delivery at 31 weeks gestation. Unfortunately, she experienced multiple complications intrapartum, including preeclampsia and placental abruption. These complications increased her risk of developing a broad ligament hematoma.

A Clinical Study to Assess the Effectiveness of Oral Combination Kit Therapy in Syndromic Management of Abnormal Vaginal Discharge (FEMINE Study) in Kinshasa, Democratic Republic of Congo

Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS® combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS® combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.

Application of Nursing Cooperation Path in Operating Room and Analysis of Complication Rate During Laparoscopic Hysterectomy

Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.

The Efficacy and Safety of Dinoprostone Vaginal Insert for Labor Induction Following Optimization of Standard Operating Procedure: A Retrospective Study in China

Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.

Vaginal microbes confounders and implications on women's health

The vagina has diverse vaginal microbes(Vm).A disturbance in the delicate balance maintained in Vm is linked to women's obstetrical and reproductive tract problems.Vaginal microbes play an essential role in protecting the health of the female reproductive tract by alleviating gynecological infection.However,Vm profiling has many confounders that need to be addressed during sampling,including age,race,pregnancy,medical illness,and smoking.Vm profiling improves reproduction odds,may serve as a marker for genital malignancies and have a therapeutic application in menopausal women and women with cervical cancers.

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.

Vaginal Progesterone (VP) versus VP plus Intermittent Intramuscular Progesterone (IMP) Use in Frozen/Thawed Blastocyst Transfer Cycles: An Observational Cohort Study

Objective: Comparison of vaginal progesterone (VP) versus VP and intermittent intramuscular progesterone (IMP) use in frozen/thawed blastocyst transfer cycles. Study Design: A single center retrospective analyses of 470 elective FET cycles which were performed between January 2015 and September 2019 were evaluated. Patients were divided into two groups. Control group was consisted of VP (n = 272), the study group was consisted of VP plus IMP (n = 198) users. Results: The number of transfer attempts in control and study groups was 272 and 198, respectively. Age (29.8 ± 4 vs 30.6 ± 4;p = 0.09), BMI (22 ± 2 vs 21.9 ± 3;p = 0.79) and the number of transferred embryos (1.4 ± 0.5 vs 1.4 ± 0.5;p = 0.48) were comparable between groups. Altough, implantation rates (43.7% vs 43.6%;p = 0.9), ectopic pregnancy (0.8% vs 0.3%;p = 0.46) and abortion rates (8.2% vs 4.8%;p = 0.07) were similar. Biochemical pregnancy rate (8.4% vs 3.4% p = 0.01) in control group and ongoing pregnancy rate (OPR) (27.9% vs 38.1%;p = 0.005) in study group were significantly higher. Conclusion: Within the FET cycles in which good quality blastocyst are being transferred additional IMP supplementation to VP may increase OPR while reducing the biochemical pregnancy rate.

Practice of Obstetrical Hysterectomy at the Sylvanus Olympio University Hospital Center: Indications and Maternal Prognosis

Obstetric hysterectomy is a surgical procedure most often performed in a context of extreme emergency in an obstetric environment. The incidence of obstetric hysterectomy is differently expressed around the world. In the CHU-SO maternity ward, hemorrhagic obstetric emergencies are common. The extreme urgency in which patients are admitted, the insufficiency of the technical platform, associated with the challenge of the availability of blood products, often leads to performing an obstetric hysterectomy for hemostasis. It is responsible for high maternal morbidity and mortality. Since 2000 no study has been carried out on this practice in the service. Objective was to describe the practice of obstetric hysterectomy at the CHU-SO and specifically to determine the prevalence, the prognostic factors to be able to act to reduce maternal mortality. Method: A descriptive, cross-sectional, and analytical study was carried out at the Gynecology-Obstetrics clinic of the CHU-SO;from January 1, 2021, to June 30, 2022. All hysterectomies performed in an obstetric emergency context (during pregnancy, perpartum or postpartum) in the department were included in our study. We did not include cases of obstetric hysterectomies outside the SO hospital or planned non-obstetric hysterectomies. Results: We recorded 75 cases of obstetric hysterectomy and 15,625 deliveries (0.48%). The average age was 32.89 ± 5.93. The age group between 30 and 35 years old was the most affected with a rate of 37.33%. Labor and third trimester hemorrhage were the main reasons for admission, patients were referred in 80% of cases. The average parity was 3.25 ± 1.92 with utmost of 0 and 11. The pauciparous (41.67%) and multiparous (32%) were the most affected. The indications frequently found were uterine atony (44%);uterine rupture (33.33%). Subtotal inter adnexal hysterectomy was performed in 94.67%. General anesthesia practiced in 69%. They were all polytransfuses. Three poor prognostic factors were observed during our study, namely: uterine atony;the state of hemodynamic shock before the operation;lack of blood transfusion. The maternal death rate was 21.33%. Conclusion: Obstetric hysterectomy is a very mutilating and complicated surgical procedure and is still common practice in Africa. The maternal prognosis is still reserved with a very high mortality rate in Togo.