A Ten-Year Retrospective Review of Emergency Obstetric Hysterectomies in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Authors

  • Confidence Chinaza Ogbomade Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • George Uchenna Eleje Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Ikechukwu Innocent Mbachu Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Charlotte Blanche Oguejiofor Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Nnamdi Azikiwe University, Awka, Nigeria
  • Chukwemeka Chukwubuikem Okoro Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • John Chukwuebuka Nkesi Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Nkejesus Chidube Obi Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Chijioke Ogomegbunam Ezeigwe Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Ahizechukwu Chigoziem Eke Division of Maternal-Fetal Medicine, Department of Gynaecology and Obstetrics, The John Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Onyecherelam Monday Ogelle Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria and Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Ekene Agatha Emeka Department of Family Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria
  • Ngozichukwu Getrude Uzoewulu Department of Medical Microbiology/Parasitology, Faculty of Basic Clinical Sciences, College of Health Sciences. Nnamdi Azikiwe Universiy Awka, Nnewi Campus
  • Victoria Victor Okon Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria

Keywords:

Retrospective Review, Nnamdi Azikiwe University, Hysterectomies, Emergency, Obstetric

Abstract

Background: In the field of obstetrics, challenges may surround the process of childbirth. One of such challenges could be life-threatening haemorrhage which may arise from varied causes. Emergency obstetric hysterectomy is a life-saving surgical procedure carried out in this instance when other methods of arresting this bleeding has failed. This has prompted this study to find out the prevalence, indications, outcome and complications of this procedure in our centre. Materials and Methods: This is a 10-year retrospective cross-sectional study of all emergency obstetric hysterectomy (EOH) cases managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria between 1st January, 2012 and 31st December, 2021. The case files of the women who had emergency obstetric hysterectomy were obtained from the medical records department of the hospital based on data extracted from the labour ward theatre register. Ethical approval for the study was obtained from the NAUTH Ethics Committee. Information relating to age, parity, gestational age, booking status, indication and type of hysterectomy, complications, and outcome were noted and evaluated. The data were compiled using Microsoft excel and analysed using SPSS version 25. Results: During the study period, 42 emergency obstetric hysterectomies (EOH) were performed out of 8,190 deliveries, resulting in a rate of 0.51%. The age group with the highest proportion of EOH was 30-39 years (60.7%). More unboooked women (89.3%) were affected than booked women. The most common indications were uterine rupture (53.6%) and uterine atony (32.1%). Subtotal hysterectomy was commonly performed (60.9%). Stable post-operative condition requiring only ward admission was achieved in 32.1% cases. Maternal mortality and fetal death occurred in 9.3% and 32.3% of the cases respectively. Conclusion: The prevalence of emergency obstetric hysterectomies in this study is comparative to that found in various studies done in other centres in Nigeria which is higher than that of high-income countries.

References

Mbakwa MR, Tendongfor N, Ngunyi YL, Ngek ESN, Alemkia F, Egbe TO. Indications and outcomes of emergency obstetric hysterectomy; a 5-year review at the Bafoussam Regional Hospital, Cameroon. BMC Pregnancy Childbirth. 2021;21(1):1-7. https://doi.org/10.21203/rs.3.rs-293973/v1

Jagun OE, Nathaniel GV, Akinseku AK. A SevenYear Review of Emergency Obstetric Hysterectomy in a Nigerian Tertiary Institution. Ann Heal Res. 2019;5(1):65-72. https://doi.org/10.30442/ahr.0501-7-37

Orazulike N, Alegbeleye J, Mba G, Uzoigwe S. Obstetric Hysterectomy As A Surgical Intervention in the Management of Obstetric Haemorrhage At the University of Port Harcourt Teaching Hospital, Nigeria. IOSR J Dent Med Sci. 2017;16(02):90-94. https://doi.org/10.9790/0853-1602029094

Rana S, Kattel P, Deep JP. Emergency Peripartum Hysterectomy at a Tertiary Care Hospital: A Five Year Analysis. Nepal J Obstet Gynaecol.

;15(2):37-41. Accessed September 7, 2021. https://www.nepjol.info/index.php/NJOG/article/view/32902

Huque S, Roberts I, Fawole B, Chaudhri R, Arulkumaran S, Shakur-Still H. Risk factors for peripartum hysterectomy among women with

postpartum haemorrhage: Analysis of data from the WOMAN trial. BMC Pregnancy Childbirth. 2018;18(1):1-8. https://doi.org/10.1186/s12884-018-1829-7

Omole-Ohonsi A, Taiwo Olayinka H. Emergency Peripartum Hysterectomy in a Developing Country. J Obstet Gynaecol Canada. 2012;34(10):954-960. https://doi.org/10.1016/s1701-2163(16)35409-3

Zhang Y, Yan J, Han Q, Yang T, Cai L, Fu Y, et al. Emergency obstetric hysterectomy for lifethreatening postpartum hemorrhage. Med (United

States). 2017;96(45):1-5. https://doi.org/10.1097/md.0000000000008443

Zargar S, Gandotra N, Kakkar T. Emergency obstetric hysterectomy: A retrospective study to evaluate incidence, indications and fetomaternal

complications in a tertiary care hospital in Jammu. Int J Clin Obstet Gynaecol. 2020;4(5):23-26. https://doi.org/10.33545/gynae.2020.v4.i5a.677

Tahlak MA, Abdulrahman M, Hubaishi NM, Omar M, Cherifi F, Magray S, Carrick FR. Emergency peripartum hysterectomy in the Dubai system health: A fifteen year experience. Turkish J Obstet Gynecol. 2018;15(1):1-7. https://doi.org/10.4274/tjod.55492

Chawla J, Arora CD, Paul M, Ajmani SN. Emergency Obstetric Hysterectomy: A Retrospective Study from a Teaching Hospital in North India over Eight Years. Oman Med J. 2015;30(3):181-186. https://doi.org/10.5001/omj.2015.39

Kallianidis AF, Maraschini A, Danis J, Colmorn LB, Deneux-Tharaux B, Donati S, et al. Epidemiological analysis of peripartum hysterectomy across nine European countries. Acta Obstet Gynecol Scand. 2020;99(10):1364-1373. https://doi.org/10.1111/aogs.13892

Gülücü S, Uzun K, Delibasi I. Retrospective Evaluation of Peripartum Hysterectomy Patients: 8 Years’ Experience of Tertiary Health Care. Niger J Clin Pract. 2022;25(4):483-489. https://doi.org/10.4103/njcp.njcp_1722_21

Wandabwa J, Businge C, Mdaka M, Kiondo P. Peripartum hysterectomy : two years experience at Nelson Mandela Academic hospital , Mthatha , Eastern Cape South Africa. Afr Health Sci. 2013;13(2):469-474. https://doi.org/10.4314/ahs.v13i2.38

Shirodker SD, Pandey A, Yadav S. Emergency obstetric hysterectomy : review at a tertiary care hospital. Int J Reprod Contraception, Obstet Gynecol. 2016;5(11):3811-3814. https://doi.org/10.18203/2320-1770.ijrcog20163845

Yildirim GY, Koroglu N, Akca A, Talmac M, Dikmen S, Yildirim G, et al. What is new in peripartum hysterectomy? A seventeen year experience in a tertiary hospital. Taiwan J Obstet Gynecol. 2021;60(1):95-98. https://doi.org/10.1016/j.tjog.2020.11.014

Kaur H, Kaur B, Kaur S. Emergency peripartum hysterectomy and its association with cesarean section: a 3 years retrospective study. Int J Reprod Contraception, Obstet Gynecol. 2018;7(5):1844. https://doi.org/10.18203/2320-1770.ijrcog20181915

Annan JJK, Konney TO, Sam-Awortwi W, Darkwa KA. Emergency hysterectomy in a tertiary care hospital: Indications, surgical outcomes and challenges: A 2year retrospective descriptive crosssectional study. Pan Afr Med J. 2020;37(106):1-11.

https://doi.org/10.11604/pamj.2020.37.106.25393

Kazi S. Emergency peripartum hysterectomy : A great obstetric challenge. Pakistan J Med Sci. 2018;34(6):1567-1570.

https://doi.org/10.12669/pjms.346.13686

Published

2022-12-31 — Updated on 2023-07-24

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Vol. 10

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