Obstetric hysterectomy for hemostasis at the Regional Hospital Center of Niamey.

Abstract

Introduction :
Obstetric hysterectomy for hemostasis is a formidable intervention with heavy consequences.

Objective :
To analyze the different aspects of obstetrical hysterectomy at the CHR in order to improve the management of immediate postpartum hemorrhage.

Materials and methods :
this was a retrospective study carried out at the CHR Poudrière in Niamey from January 1 to December 31, 2017. The cases of patients who underwent emergency obstetric hysterectomy and their newborn were included.

Results :
We collected 23 cases of obstetrical hysterectomy due to hemostasis among the 6643 deliveries, i.e. a frequency of 0.35%. The mean age was 27.3 ±9.6 years (extremes: 18 and 40 years) and the age group of 21 to 25 years represented 39.13% (n=9); multiparas represented 52.17% including 30.43% with a scarred uterus. The patients who had benefited from 3 to 4 prenatal follow-ups represented 43.48% (n=10). The main reasons for admission were uterine rupture (65.2%); retroplacental hematoma (13.04%). Thus 19 subtotal hysterectomies were performed (82.61%) and 4 total hysterectomies (17.39%). Nine of our patients had benefited from blood transfusion. Unfortunately, we recorded 7 cases of maternal deaths, i.e. 30.44%, and 17 stillbirths, i.e. 73.91% Conclusion: Obstetric hysterectomy for hemostasis was performed mainly in multiparas and morbidity and mortality was high.