BACKGROUND: Obstetric haemorrhage is the leading direct cause of maternal mortality in South Africa. OBJECTIVE: To determine the incidence, indications, associations and maternal outcomes of emergency peripartum hysterectomies. METHODS: A descriptive and retrospective analysis of patients who had peripartum hysterectomy between 1(st) February 2007 and 31(st) January 2009 in Nelson Mandela Academic Hospital at Mthatha city. RESULTS: The incidence of 0.95% of peripartum hysterectomies (n=63 or 9.5/1000 births) increased with the increasing maternal age from 0.121% at age of less than 20 years to 0.5% at age more or equal to 30 years. Similarly the incidence increased with parity from 0.332% for Primiparity to 0.468% at parity of four or more. The indications for the operation were uterine atony 19/63 (30.2%), secondary haemorrhage/puerperal sepsis 17/63 (27%) and ruptured uterus 16/63 (23.4%). The main intra operative complication was haemorrhage 13/63 (20.6%). Repeat laparotomy was done in 10/63 (15%) of patients due to haemorrhage. Admission to intensive care unit was 25/63 (39.7%). The case specific mortality rate was of 19 % (n=12). The main causes of death were hypovolaemic shock and septicemia. CONCLUSION: The incidence of peripartum hysterectomies was high and was associated with ruptured uterus and puerperal sepsis which are preventable.
BACKGROUND: Obstetric haemorrhage is the leading direct cause of maternal mortality in South Africa. OBJECTIVE: To determine the incidence, indications, associations and maternal outcomes of emergency peripartum hysterectomies. METHODS: A descriptive and retrospective analysis of patients who had peripartum hysterectomy between 1(st) February 2007 and 31(st) January 2009 in Nelson Mandela Academic Hospital at Mthatha city. RESULTS: The incidence of 0.95% of peripartum hysterectomies (n=63 or 9.5/1000 births) increased with the increasing maternal age from 0.121% at age of less than 20 years to 0.5% at age more or equal to 30 years. Similarly the incidence increased with parity from 0.332% for Primiparity to 0.468% at parity of four or more. The indications for the operation were uterine atony 19/63 (30.2%), secondary haemorrhage/puerperal sepsis 17/63 (27%) and ruptured uterus 16/63 (23.4%). The main intra operative complication was haemorrhage 13/63 (20.6%). Repeat laparotomy was done in 10/63 (15%) of patients due to haemorrhage. Admission to intensive care unit was 25/63 (39.7%). The case specific mortality rate was of 19 % (n=12). The main causes of death were hypovolaemic shock and septicemia. CONCLUSION: The incidence of peripartum hysterectomies was high and was associated with ruptured uterus and puerperal sepsis which are preventable.
Authors: Maura K Whiteman; Elena Kuklina; Susan D Hillis; Denise J Jamieson; Susan F Meikle; Samuel F Posner; Polly A Marchbanks Journal: Obstet Gynecol Date: 2006-12 Impact factor: 7.661
Authors: José Villar; Eliette Valladares; Daniel Wojdyla; Nelly Zavaleta; Guillermo Carroli; Alejandro Velazco; Archana Shah; Liana Campodónico; Vicente Bataglia; Anibal Faundes; Ana Langer; Alberto Narváez; Allan Donner; Mariana Romero; Sofia Reynoso; Karla Simônia de Pádua; Daniel Giordano; Marius Kublickas; Arnaldo Acosta Journal: Lancet Date: 2006-06-03 Impact factor: 79.321
Authors: Nicolae Gică; Carina Ragea; Radu Botezatu; Gheorghe Peltecu; Corina Gică; Anca Maria Panaitescu Journal: Medicina (Kaunas) Date: 2022-01-12 Impact factor: 2.430