Document Detail


Emergency peripartum hysterectomy in a Nigerian hospital: a 20-year review.
MedLine Citation:
PMID:  15203573     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Postpartum haemorrhage is a major cause of maternal morbidity and mortality and occasionally severe enough to warrant hysterectomy to prevent maternal death. Hysterectomy often is fraught with danger and regular audit is necessary to assist in the reduction of these dangers. A 20-year audit of all emergency peripartum hysterectomies, performed at Havana Specialist hospital Lagos, Nigeria, is reported. Of the 6599 deliveries and peripartum referrals seen during the period, 22 had an emergency hysterectomy as a result of severe postpartum haemorrhage (0.33%). The aetiological factors associated with the postpartum haemorrhage included uterine atony (45.5%), placenta praevia (27.3%), pathologically adherent placenta (18.2%) and ruptured uterus (9.1%). The majority of the procedures were subtotal hysterectomy (81.8%) and the mean operative time was significantly shorter than for total hysterectomy (P<0.05). The postoperative complications included postoperative anaemia (28.6%), febrile morbidity (36.9%), wound infection (19.0%) and urinary tract infection (9.5%), together with three maternal deaths. In conclusion, emergency peripartum hysterectomy, although life-saving, is associated with severe morbidity and mortality and subtotal hysterectomy is usually the operation of choice.
Authors:
O C Ezechi; B K E Kalu; F O Njokanma; C A Nwokoro; G C E Okeke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology     Volume:  24     ISSN:  0144-3615     ISO Abbreviation:  J Obstet Gynaecol     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-18     Completed Date:  2004-07-29     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8309140     Medline TA:  J Obstet Gynaecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  372-3     Citation Subset:  IM    
Affiliation:
Havana Specialist Hospital, Surulere, Lagos, Nigeria. oezechi@yahoo.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Emergency Treatment / utilization*
Female
Hospitals, Urban
Humans
Hysterectomy / methods,  utilization*
Incidence
Medical Audit
Medical Records
Nigeria / epidemiology
Obstetric Labor Complications / epidemiology*,  etiology,  surgery*
Postoperative Complications
Postpartum Hemorrhage / epidemiology,  etiology,  surgery
Pregnancy
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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