Profiles and outcomes of women undergoing hysterectomy for primary postpartum haemorrhage at Chris Hani Baragwanath Hospital

• Main Author: Hassim, Taheera
• Format: Others
• Language: en
• Published: 2013
• Subjects: Hysterectomy; Gynecology
• Online Access: http://hdl.handle.net/10539/12720

Thesis (M.Med.(Obstetrics and Gynaecology)--University of the Witwatersrand, Faculty of Health Sciences, 2012 === Objective The study aimed to identify the profiles and outcomes of women undergoing hysterectomy for primary postpartum haemorrhage (PPH). Methods This was a retrospective descriptive study of maternal records of all women that underwent hysterectomy for primary postpartum haemorrhage (PPH) from January 2008 to December 2008. Results Twenty-seven women underwent hysterectomies for primary postpartum haemorrhage (PPH). Eighty nine percent of the women were booked, with a mean of 4.8 antenatal visits. Previous caesarean section and retained placenta were the main risk factors associated with hysterectomy for PPH, with retained placentae being the principle etiological factor (37% of cases). Forty percent of patients had one or more previous caesarean section. Atony was the leading cause of emergency hysterectomy (63%). Subtotal hysterectomy appeared to be the procedure of choice (70% of cases). Conservative management was not attempted in most cases. After hysterectomy, 18(29%) of women were admitted to the multidisciplinary intensive care unit. Two women died (7%). Conclusion Postpartum haemorrhage requiring hysterectomy appears to be an unpredictable emergency with no specific risk profile for peripartum hysterectomy. Conservative management could have been attempted more frequently. The findings have implications for peripheral hospitals that manage obstetric patients who have no specific risk factors for PPH. The possibility of emergency hysterectomies exists for all births and health workers need to be able to recognize and manage this emergency appropriately. Peripartum hysterectomy (PH) may be a lifesaving procedure and every obstetric doctor needs to be proficient in performing a subtotal hysterectomy at the very least.