Emergency peripartum hysterectomy in the nulliparous patient.

OBJECTIVE

To find out the incidence, indications and outcomes of emergency peripartum hysterectomy in the nulliparous woman.

METHOD: Retrospective study at the Korle Bu Teaching Hospital in Accra, Ghana, between January 1995 and December 2003.

RESULTS

During the eight-year study period there were 92,966 deliveries out of which 36,550 (39.5%) were for the nulliparous. Peripartum hysterectomy was performed for 39 nulliparous women, thus giving an incidence of 1 per 1000 nulliparous deliveries. The indications for the hysterectomy were: atonic uterus 28 (71.8%), ruptured uterus 8 (20.5%) and placenta praevia/accreta 3 (7.7%). The perinatal losses were 8 (20.5%) and the total blood loss ranged from 1 to 4.5 l. There were no maternal deaths but there were 7 near-missed fatalities.

CONCLUSION

Though rare, peripartum hysterectomy in the nulliparous patients carries high maternal morbidity and perinatal mortality.