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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905
EISSN: 1680-6905
Vol. 13, No. 2, 2013, pp. 469-474
Bioline Code: hs13066
Full paper language: English
Document type: Research Article
Document available free of charge

African Health Sciences, Vol. 13, No. 2, 2013, pp. 469-474

 en Peripartum hysterectomy: two years experience at Nelson Mandela Academic hospital, Mthatha, Eastern Cape South Africa
Wandabwa, J N; Businge, C; Longo-Mbenza, B; Mdaka, M L & Kiondo, P

Abstract

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 1st February 2007 and 31st 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.

Keywords
secondary haemorrhage; Ruptured uterus; Uterine atony; Hysterectomy; Peripartum

 
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