Emergency obstetric hysterectomy in eastern Nigeria

This study was undertaken to determine the incidence of morbidity and mortality of emergency obstetric hysterectomy at the University of Nigeria Teaching Hospital, Enugu, and also the modalities for reducing these complications. Of the 84 cases of emergency obstetric hysterectomy carried out at the Teaching Hospital between January 1979 and December 1988, 43 had antenatal care at the Teaching Hospital while the remaining 41 were referred cases. Sixty patients were operated upon for ruptured uterus while the remaining 24 were as a result of post partum causes such as uterine atony, adherent placenta, lacerated cervix and sepsis. The leading post-operative complications were fever, haemorrhagic shock and sepsis. A maternal mortality rate of 29.8% was recorded, with the referred patients contributing 68% of the mortality. Better supervision of antenatal care in the community studied, improved blood transfusion facilities in the Teaching Hospital and adequate prophylaxis with antibiotics are recommended to reduce morbidity and mortality in operated cases.