EMERGENCY PERIPARTUM HYSTERECTOMY IN A LOW RESOURCE SETTING : A 5-YEAR ANALYSIS

Bassey G. MBBS,FWACS,FMCOG, Akani C.I. MBBS,FWACS,FICS

Available online Jul 19, 2018.

[ Original ] Volume 23, Issue 2, 2014, Pages 170-175


Abstract

BACKGROUND: Emergency peripartum hysterectomy (EPH) is an important life saving surgical procedure often necessitated by
life threatening obstetric haemorrhage. The indications for peripartum hysterectomy differs between develop and developing
countries and may reflect the level of obstetric practice in a region.
PATIENTS AND METHODS: This was a 5-year retrospective study. The medical records of patients who had emergency peripartum
hysterectomy at the University of Port Harcourt Teaching Hospital were reviewed and relevant data were retrieved and analyzed.
RESULTS: Sixty two cases of peripartum hysterectomy were performed giving a prevalence rate of 0.38% out of 16,113 total
2 deliveries. Being unbooked was significantly associated with peripartum hysterectomy (x =85.29,p=0.0000). Peripartum
hysterectomy was performed for 20.3% of nulliparous women. Subtotal hysterectomy accounted for 55.9% while total hysterectomy
was performed for 44.1% of cases. The commonest indication for peripartum hysterectomy was uterine rupture (57.6%). There was
no case of ureteric injury. Unbooked mothers were 28 times more likely to die than booked mothers. Unbooked status was
significantly associated with maternal mortality ( p=0.00008 ) and perinatal mortality (p=0.00000).
CONCLUSION: Emergency peripartum hysterectomy still remains indispensible in obstetric practice in low resource setting.
Labour and delivery when well supervised will reduce the need for emergency peripartum hysterectomy. Training of specialist in the
skill of internal iliac artery ligation is recommended.


Keywords

Peripartum hysterectomy, booking status, uterine rupture, postpartum haemorrhage.,

April - June 2014

Volume 23 | Issue 2

Page Nos. 170-175

Online since Jul 13, 2018

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