Abstract:
Objectives: The main objectives of this study
were to determine the incidence, maternal characteristics,
indications, the maternal and perinatal
outcomes and the complications of emergency
peripartum hysterectomies done at the Korle-Bu
Teaching Hospital.
Study design: This is a retrospective descriptive
study covering the period January 1, 2000 to June
30, 2003.
Setting: Maternity Unit of the Korle-Bu Teaching
Hospital
Results: The incidence of peripartum hysterectomy
during the study period was 4.34/1000 deliveries.
The main indication was severe uterine
bleeding from uterine rupture 89 (48.9%), uterine
atony 60 (33%), placenta accreta 20 (11%) and
post caesarean uterine wound sepsis and necrosis
11 (6%).
The average blood loss was 2.02 (SD 0.86) L and
all patients received blood transfusion. The mean
age of the patients was 31.6 (SD 5.3) years and the
mean parity was 2.7 (SD 1.7). Complications occurred
in 28 (19.8%) patients.
The stillbirth rate was 483.5/1000 deliveries and
the maternal mortality was 12.9%. The average
duration of hospital stay was 11 (SD 8) days.
Conclusions: The incidence of emergency peripartum
hysterectomy is high. It is performed for
young nulliparous women through to elderly
grand-multiparous women. The surgery is associated
with significant maternal and perinatal morbidity
and mortality. Timely expert management in
a well resourced centre is advocated.