Peripartum hysterectomy in Aba southeastern Nigeria

Umezurike, Chisara C.; Feyi-Waboso, P; Adisa, Charles

doi:10.1111/j.1479-828x.2008.00905.x

Cited by 44 publications

(81 citation statements)

References 17 publications

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“…Similar indications have been reported in Durban and Ghana 2,3 . These were different from that of southern Nigeria where placenta accreta was the main indication 1 . However uterine atony and abnormal placentation remain the main indication of hysterectomies in developed countries 9-12, 14, 18. The indications for peripartum hysterectomies at NMAH and similarly in Ghana give an insight of level of obstetric care in that puerperal sepsis/ secondary post partum haemorrhage and ruptured uterus contributed 50% of the indications.…”

Section: Discussioncontrasting

confidence: 73%

“…2,3 Out of the 63 women twelve died making the case maternal mortality rate of 19%. This was higher than what has been reported in Ghana of 12.6% 2 and Turkey of 11.6% 18 but was lower than what was reported in southern Nigeria of 23.6% 1 . Some developed countries have reported zero mortality and this is accounted for by better obstetric care.…”

Section: Discussioncontrasting

confidence: 69%

“…In United Kingdom it is 0.41/ 1000 births 7 , Denmark it is 0.24/1000 births 9 , in Saudi Arabia it is 0.64/1000 10 , in Korle Bu Ghana it is 4.34/1000 2 , Nigeria 5.4/1000 1 and Durban in South Africa 5.1/1000. 3 The differences have been attributed to the different levels of obstetric care offered.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] Haemorrhage remains a significant cause of maternal mortality worldwide and even in United Kingdom 4 . In South Africa it's the second leading direct cause of maternal mortality.…”

Section: Introductionmentioning

confidence: 99%

“…5 Life threatening haemorrhage due to uterine rupture and atony of uterus continue to pose a major problem in obstetric care in developing countries 6 and is a major cause of peripartum hysterectomies 2,3 . The other indications of peripartum hysterectomy are placenta accreta, increta, and percreta and, uterine infection 1,2,7 . Peripartum hysterectomy has been used as one of the definitions of near miss events or acute severe maternal morbidity.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Peripartum hysterectomy: Two years experience at Nelson Mandela Academic hospital, Mthatha, Eastern Cape South Africa

Wandabwa¹,

Businge²,

Longo-Mbenza³

et al. 2013

Afr H. Sci.

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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.

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Section: Discussioncontrasting

confidence: 73%