Emergency peripartum hysterectomy: a retrospective analysis in a tertiary care hospital in Jharkhand, India

Bhagat, Megha; Moitra, Bratati

doi:10.18203/2320-1770.ijrcog20183313

Cited by 1 publication

(3 citation statements)

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“…In India this rate varies from 0.12% to 0.57%. [9][10][11][12][13] In Africa, this prevalence varies between 0.2% and 0.62%. [14][15][16] The highest frequency is reported by Nayama et al, in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

“…29 In India, this rate varies between 26% and 88.09%. 11,12,23,30 Total hysterectomy is indicated for placenta accreta, which is the main indication in developed countries. Indeed, subtotal hysterectomy is indicated if the source of the bleeding is upstream of the lower segment.…”

Section: Discussionmentioning

confidence: 99%

“…In India, maternal mortality ranges from 2.2% to 16.7%. [9][10][11][12]23,30 Studies in Africa have found a higher frequency. Obiecchina found up to 31% of maternal deaths, Nayama found 21.95% of deaths.…”

Section: Discussionmentioning

confidence: 99%

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Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

Tanjona

Romuald

Mahefa

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Postpartum hemorrhage is one of the leading causes of maternal death in the entire world. It affects 10% of deliveries. Emergency peripartum hysterectomy (EPH)defined as a lifesaving procedure involving the removal of the uterus to treat severe postpartum hemorrhage is one of the last-resort treatments for severe postpartum hemorrhage in case of failure of other techniques. Through this study, we aimed both to describe the epidemiological profile, to determine the etiologies, and maternal complications of EPH.Methods: It is about a descriptive retrospective study from January 1st, 2016 to January 1st, 2017 at the Befelatanana University Hospital of Obstetrics and Gynecology. We included all patients who underwent Emergency peripartum hysterectomy after 22 weeks of Amenorrhea (WA) regardless of the delivery route in the centre. We used the R software for the statistical analysis of the results.Results: We had 31 cases of EPH during this period with a prevalence of 0.44%. The average age was 26.38±5.61 years. Mean gestational age was 37±3.59 weeks of amenorrhea. In the 83.87% of cases, the patient received less than four prenatal consultations. Patients were referred in 45.16% of the cases. The delivery route was by cesarean section in 48.39% of cases. Eleven patients (35.48%) received a blood transfusion. Hysterectomy was subtotal in 96.77% of the cases. We had five (16.13%) maternal deaths during the study period. The leading cause of death was hemorrhagic shock (80%). The etiology of hysterectomy was dominated by uterine atony complicated by hemorrhage (48.39%), followed by retroplacental hematoma (25.81%) and uterine rupture (22.58%).Conclusions: EPH still holds its place in the management of postpartum hemorrhage in Madagascar. Maternal mortality remains high. Uterine atony was the most common indication for EPH. The prevention of postpartum hemorrhage by management of the third stage of labour should be carried out by any health actor.

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