Open AccessA Seven-Year Review of Emergency Obstetric Hysterectomy in a Nigerian Tertiary Institution
Author(s) -
Olusoji Edward Jagun,
Gbenga Victor Nathaniel,
Adeniyi Kazeem Akinseku
Publication year - 2019
Publication title -
annals of health research
Language(s) - English
Resource type - Journals
ISSN - 2536-6149
DOI - 10.30442/ahr.0501-7-37
Subject(s) - medicine , retrospective cohort study , incidence (geometry) , hysterectomy , obstetrics , gestational age , observational study , pregnancy , blood transfusion , psychological intervention , uterine rupture , pediatrics , uterus , surgery , physics , pathology , psychiatry , biology , optics , genetics
Background: Extirpative uterine surgeries for near-miss events are usually the last resort when other conservative measures fail. Emergency obstetric hysterectomy (EOH) may still have a significant role where there are limited options. Objectives: To determine the prevalence of EOH, the associated factors and the foeto-maternal outcome at the Olabisi Onabanjo University Teaching Hospital, Nigeria. Methods: This was a retrospective observational study covering seven years (January 2010 to December 2016). The case records of patients who had EOH during this period were retrieved for data extraction. Results: There were 5, 608 deliveries and 31 cases requiring EOH giving a prevalence rate of 31/5,608 (0.55%). The mean age of the patients was 30.3±4.2 years, while the mean gestational age at delivery was 36.3±5.1 weeks. Most of the patients 16/25 (64.0%) were of higher parity (>3), and 12/25 (48%) of the patients were within the age bracket of 25-34 years. Subtotal hysterectomy was the most common procedure (18; 72.0%), and ruptured uterus was the main indication for EOH (40.0%). The two most common interventions that were critical to survival included massive blood transfusion (24.0%) and Intensive Care Unit admission (20%). Two (8%) maternal deaths and 58.3% perinatal mortality were recorded. Conclusion: EOH is still relatively frequently performed at this centre due to the high incidence of a ruptured uterus. Efforts should be made to increase the proportion of deliveries attended by skilled personnel and improve the capacity of lower level hospitals for comprehensive emergency obstetric care.