Case control study on determinants of emergency peripartum hysterectomy among mothers managed at Hawassa University Comprehensive Specialized Hospital.

BACKGROUND

Peripartum hysterectomy is the removal of the uterus during a cesarean section, after vaginal delivery, or during puerperium. It is usually performed as a life-saving emergency during abnormal placentation, hemorrhage, or uterine rupture. It has a substantial role in the prevention of maternal mortality and morbidity. This study aimed to identify the determinants of emergency peripartum hysterectomy at Hawassa University Comprehensive Specialized Hospital, Ethiopia.

METHODS

A hospital-based, unmatched case-control study was conducted among 66 cases and 198 controls with a case-to-control ratio of 1:3 in HUCSH from September 2018 GC to September 2022 GC. A pre-tested checklist was used, and data was collected using the ODK (open data kit). The data was downloaded, exported to XLS and imported to SPSS Version 26 for further analysis. The association between independent variables and peripartum hysterectomy was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at a P-value < 0.05.

RESULTS

The results showed that women with parity ≥ 5 times [AOR: 3.34), 95%CI: (1.17–9.49], previous cesarean section history [AOR = 3.15, 95%CI: (1.26–7.89], labor abnormality[AOR = 4.54, 95%CI: (1.87–11.01], post-partum hemorrhage [AOR = 5.63, 95%CI: (2.07–15.3)]and fetal mal-presentation [AOR = 4.75, 95%CI: (1.48–15.31)] were associated with emergency peripartum hysterectomy.

CONCLUSION

In this study, grand multiparity, history of cesarean section, postpartum hemorrhage, labor abnormality, and fetal malpresentation were factors that significantly increased the odds of undergoing peripartum hysterectomy. So, improvement in the intrapartum and postpartum quality of obstetric care delivered is recommended.