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 ...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.展开更多
Introduction: Pregnancy, childbirth, and their consequences continue to be the leading cause of death, illness, and disability among women of reproductive age in developing countries. In Niger, maternal deaths account...Introduction: Pregnancy, childbirth, and their consequences continue to be the leading cause of death, illness, and disability among women of reproductive age in developing countries. In Niger, maternal deaths account for about 39% of all deaths of women aged 15-49. Our aim was to identify the factors linked to maternal mortality in order to contribute to its reduction. Method: this is a descriptive retrospective study of 379 cases of maternal deaths collected at the Maradi CSME from January 1, 2018, to December 31, 2021.Results: Our study’s maternal mortality ratio is 2645.72 per 100,000 live births. The mean age of our patients was 27.46 years, with extremes ranging from 15 to 47 years. The 20-24 age group was the most represented, with 88 cases (23.2%). Housewives were 361 (95.3%), and 334 patients (88.1%) were uneducated. There were 261 of them from rural areas, i.e. 69%. The mean parity in our study was 3.46, with extremes ranging from 0 to 15. Multiparous patients 117 cases (30.9%) represented the most significant proportion. Only 42 patients (11.08%) had performed four or more antenatal consultations. Direct obstetric causes accounted for 56.73% of the causes of maternal death. Anemia was the leading cause of maternal death (31.66%). Nearly half of the patients had died before 24 hours after admission, i.e. 49.86%. Conclusion: Maternal mortality remains a significant challenge for developing countries, given its magnitude and timid decline. The fight to reduce maternal mortality must be the priority of our countries’ health policies.展开更多
文摘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.
文摘Introduction: Pregnancy, childbirth, and their consequences continue to be the leading cause of death, illness, and disability among women of reproductive age in developing countries. In Niger, maternal deaths account for about 39% of all deaths of women aged 15-49. Our aim was to identify the factors linked to maternal mortality in order to contribute to its reduction. Method: this is a descriptive retrospective study of 379 cases of maternal deaths collected at the Maradi CSME from January 1, 2018, to December 31, 2021.Results: Our study’s maternal mortality ratio is 2645.72 per 100,000 live births. The mean age of our patients was 27.46 years, with extremes ranging from 15 to 47 years. The 20-24 age group was the most represented, with 88 cases (23.2%). Housewives were 361 (95.3%), and 334 patients (88.1%) were uneducated. There were 261 of them from rural areas, i.e. 69%. The mean parity in our study was 3.46, with extremes ranging from 0 to 15. Multiparous patients 117 cases (30.9%) represented the most significant proportion. Only 42 patients (11.08%) had performed four or more antenatal consultations. Direct obstetric causes accounted for 56.73% of the causes of maternal death. Anemia was the leading cause of maternal death (31.66%). Nearly half of the patients had died before 24 hours after admission, i.e. 49.86%. Conclusion: Maternal mortality remains a significant challenge for developing countries, given its magnitude and timid decline. The fight to reduce maternal mortality must be the priority of our countries’ health policies.
