Post Emergency Obstetric Hysterectomy Morbidities in the University of Port Harcourt Teaching Hospital - A Five Year Review.

Abstract

Background: Hysterectomy in the peripartum period is a life-saving emergency procedure that is associated with both intra-operative and post-operative morbidities. This study aims to determine the prevalence of emergency obstetric hysterectomy (EOH), the indications, and the pattern of post-emergency obstetric hysterectomy complications and their outcome in our setting.

Methodology: This was a retrospective study of parturients that had an emergency obstetric hysterectomy (EOH) over a five (5)-year period from 1^st January 2008 – 31^st December 2012. The case records of these patients were retrieved from the medical record library and information relating to age, parity, booking status, indications, type of hysterectomy, and complications of the procedure were extracted. The data obtained were analysed using the statistical product and service solutions (SPSS) 15.0.

Results: There were 16,720 deliveries during the five-year period of the study. Emergency obstetric hysterectomies were performed in sixty-nine patients giving a prevalence of 0.4% or 1:242 (4.1 per 1,000) deliveries. Uterine rupture, 33(47.8%) was the leading indication, while the subtotal hysterectomy was the commonest surgery performed 42 (60.9%). The commonest post-hysterectomy morbidities were anaemia, 60 (86.9%) and wound sepsis, 16 (23.2%). Maternal mortality occurred in 7 patients giving a case fatality rate of 10.1%.

Conclusions: The prevalence of EOH in this study was high with uterine rupture as the leading indication. Wound sepsis and anaemia were the most common post-EOH complications and the case fatality rate was high. Measures must be put in place to prevent uterine rupture and obstetric haemorrhage in our setting.