Morbidity of total abdominal hysterectomy at the University of Maiduguri Teaching Hospital, Maiduguri, Nigeria

Abstract

Background: Total abdominal hysterectomy is a commonly performed gyneacological procedure. Although it is safe, it can still be associated with development of complication. The aim of this study was to determine morbidity associated with total abdominal hysterectomy in our environment.
Method: All cases of total abdominal hysterectomy done over a five-year period (January 2003 December 2006) at the University of Maiduguri Teaching Hospital (UMTH) were reviewed. Information was obtained from the patients' case notes, gynaecology ward, and theatre records. The complications of the procedure were determined. Multiple logistic regression was used to find the factors that were independently associated with development of complications.
Results: During the study there were 101 cases of total abdominal hysterectomy out of 729 gynaecological operations, a rate of 13.8%. In majority of the cases 56(68.3%) the indication of the hysterectomy was
uterine fibroid (symptomatic). Overall 37(45.1%) experience some form of complication out of which 26(70.3%) was febrile morbidity. Finding enlarged uterus intraoperatively {OR(95%CI)= 14.5(1.84-114.6), p=0.011}, blood transfusion {OR(95%CI)= 31.1(1.35-718.8), p=0.032}and postoperative PCV <30% {OR(95%CI)= 9.63(1.14-81.3) p=0.037}were found to be significantly associated with development of complication.
Conclusions: Total abdominal hysterectomy was associated with development of complications and enlarged uterus, increasing parity independent risk factors for development of the complication

Key Words: Total abdominal hysterectomy, Indications, Complications, UMTH.