Emergency Obstetric Hysterectomy in a Low Resources Country: An Eight-Year Retrospective Cohort Study from a Secondary Care Hospital in Niger  

作　　者：Amadou Issa Abdou Hamidou Soumana Diaouga Zalika Salifou Lankoandé Souley Ibrahim Lailata Maina Oumara Harouna Salifou Jamila Salamatou Guédé Younsou Ganda Moussa Boukari Oumarou Garba Souleymane Hamissou Souley M. Noury Madi Nayama Amadou Issa Abdou;Hamidou Soumana Diaouga;Zalika Salifou Lankoandé;Souley Ibrahim Lailata;Maina Oumara;Harouna Salifou Jamila;Salamatou Guédé;Younsou Ganda;Moussa Boukari;Oumarou Garba Souleymane;Hamissou Souley M. Noury;Madi Nayama(Department of Obstetrics & Gynecology, Mother and Child Health Centre, Dan Dicko Dankoulodo University of Maradi, Maradi, Niger;Department of Obstetrics & Gynecology, Issaka Gazoby Maternity Hospital, Abdou Moumouni University in Niamey, Niamey, Niger;Department of Obstetrics & Gynecology, Mother and Child Health Centre, Andre Salifou University of Zinder, Zinder, Niger;Department of Obstetrics & Gynecology, General Referal Hospital, Abdou Moumouni University in Niamey, Niamey, Niger;Department of Anesthesia, Referal Hospital in Maradi, Maradi, Niger)

机构地区：[1]Department of Obstetrics & Gynecology, Mother and Child Health Centre, Dan Dicko Dankoulodo University of Maradi, Maradi, Niger [2]Department of Obstetrics & Gynecology, Issaka Gazoby Maternity Hospital, Abdou Moumouni University in Niamey, Niamey, Niger [3]Department of Obstetrics & Gynecology, Mother and Child Health Centre, Andre Salifou University of Zinder, Zinder, Niger [4]Department of Obstetrics & Gynecology, General Referal Hospital, Abdou Moumouni University in Niamey, Niamey, Niger [5]Department of Anesthesia, Referal Hospital in Maradi, Maradi, Niger

出　　处：《Open Journal of Obstetrics and Gynecology》2024年第10期1611-1627,共17页妇产科期刊（英文）

摘　　要：Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.Introduction: Emergency obstetric hysterectomy (EOH) is a lifesaving procedure that is performed as a last resort in cases of severe postpartum haemorrhage. Objective: The objective of this study was to determine the incidence, socio-demographic profile of patients, indications, management and maternal-fetal outcomes of EOH in a maternity hospital with limited resources in Niger. Methodology: This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent emergency obstetric hysterectomies between 1 January 2015 and 31 December 2022 at the Mother and Child Health Centre (MCHC) in Maradi, Niger. The epidemiological data, indications, and outcomes of EOH were collated and subjected to analysis using the statistical software package SPSS 21.0. Comparisons were made using the Chi-squared test. A p-value of less than 0.05 was considered statistically significant. Results: During the study period, 239 cases of emergency obstetric hysterectomy were recorded out of 269,710 deliveries, representing a frequency of 0.89%. The mean age of the patients was 32.41 years (range: 17 - 50 years). The patients were identified as married (239 cases, 100%), unemployed (228 cases, 95.4%), and not attending school (215 cases, 90%). The largest number of cases were observed in large multiparous women (i.e., those with more than five children), representing 58.6% of the total number of cases (140 patients). The average parity among this group was 6.15 children. The majority of patients (229 patients, 95.82%) had undergone in utero transfer, with 169 patients (70.71%), originating from peripheral maternity units in the Maradi region. Upon admission, 116 patients (48.53%) exhibited active genital haemorrhage, while 58 patients (24.26%) were in shock. The primary indications for hysterectomy were uterine rupture (153 patients, 64%), uterine atony (77 patients, 32.2%), and placental accreta (six patients, 2.5%). Hysterectomy was performed by an obstetric gynaecologist (230 patients, 96.

关 键 词：Emergency Obstetrical Hysterectomy Postpartum Hemorrhage Maternal Mortality NIGER 

分 类 号：R73[医药卫生—肿瘤]