Incidence, indications, and maternal outcomes of emergency peripartum hysterectomy at a tertiary hospital in Ethiopia: A retrospective review

Objective To determine the incidence, indications, and maternal outcomes of emergency peripartum hysterectomy (EPH) at a tertiary setting in Ethiopia. Materials and methods A 4-year retrospective review of EPH cases was conducted at St. Paul's Hospital Millennium Medical College (Ethiopia) from January 2016 to December 2019. Data were collected by reviewing maternal charts of EPH cases using a structured data extraction format. Stata Statistical Software, release 14, was used for data analysis. Frequency and percentages are used to present the significance of results. Results Among 39 629 deliveries during the study period, there were 105 EPH, making the incidence rate 2.6 per 1000 deliveries. The common indications for EPH were uterine rupture (63/105; 60%), intractable uterine atony (23/105; 21.9%), and placenta accreta spectrum (14/105; 14.7%). The most common complications were anemia (85/105; 80.9%), puerperal fever (13/105; 12.4%), acute kidney injury (10/105; 9.5%), and relaparotomy (7/105; 6.7%). Conclusion The incidence of EPH observed in our institution is high. Appropriate patient selection for vaginal delivery and strict labor follow up with early intervention for labor abnormalities should be the guiding principles of optimal obstetrical care to alleviate the burden of uterine rupture.