Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 103-109 |
| Journal | International Journal of Gynecology and Obstetrics |
| Volume | 146 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jul 2019 |
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A district-wide population-based descriptive study of emergency peripartum hysterectomy in a middle-income country. / Heitkamp, Anke; Seinstra, Jorrit; van den Akker, Thomas; Vollmer, Linda; Gebhardt, Stefan; van Roosmalen, Jos; de Vries, Johanna I.; Theron, Gerhard.
In: International Journal of Gynecology and Obstetrics, Vol. 146, No. 1, 01.07.2019, p. 103-109.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - A district-wide population-based descriptive study of emergency peripartum hysterectomy in a middle-income country
AU - Heitkamp, Anke
AU - Seinstra, Jorrit
AU - van den Akker, Thomas
AU - Vollmer, Linda
AU - Gebhardt, Stefan
AU - van Roosmalen, Jos
AU - de Vries, Johanna I.
AU - Theron, Gerhard
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: To determine incidence, risk indicators, and outcomes of emergency peripartum hysterectomy (EPH) in Metro East, Cape Town, South Africa. Methods: A population-based district-wide prospective descriptive study of EPH in public hospitals from November 2014 to November 2015. Women were enrolled by using the WHO maternal near miss tool and followed until discharge. EPH was defined as hemorrhage or infection leading to hysterectomy during pregnancy or within 42 days of delivery. Results: Fifty-nine women experienced EPH with an overall incidence of 14.3 per 10 000 women: 32 procedures were for postpartum hemorrhage, 27 for puerperal sepsis. Two women died: one from sepsis; one from hemorrhage. Overall, 51 (86%) women delivered by cesarean, and 23/51 (45%) by repeat cesarean. As compared with hemorrhage, EPH for sepsis involved older women (mean age, 31.5 vs 24.4 years) and those with higher gravidity (median, 3 vs 1), and was associated with longer hospital admission (median, 11.5 vs 4 days), with occurrence later postpartum (median, 8 vs 0 days), and more frequently with complications. Conclusions: The incidence of EPH for sepsis was higher than previously reported. Repeat cesarean was strongly associated with EPH. Clinical characteristics of sepsis-related EPH compared unfavorably with those of hemorrhage-related EPH.
AB - Objective: To determine incidence, risk indicators, and outcomes of emergency peripartum hysterectomy (EPH) in Metro East, Cape Town, South Africa. Methods: A population-based district-wide prospective descriptive study of EPH in public hospitals from November 2014 to November 2015. Women were enrolled by using the WHO maternal near miss tool and followed until discharge. EPH was defined as hemorrhage or infection leading to hysterectomy during pregnancy or within 42 days of delivery. Results: Fifty-nine women experienced EPH with an overall incidence of 14.3 per 10 000 women: 32 procedures were for postpartum hemorrhage, 27 for puerperal sepsis. Two women died: one from sepsis; one from hemorrhage. Overall, 51 (86%) women delivered by cesarean, and 23/51 (45%) by repeat cesarean. As compared with hemorrhage, EPH for sepsis involved older women (mean age, 31.5 vs 24.4 years) and those with higher gravidity (median, 3 vs 1), and was associated with longer hospital admission (median, 11.5 vs 4 days), with occurrence later postpartum (median, 8 vs 0 days), and more frequently with complications. Conclusions: The incidence of EPH for sepsis was higher than previously reported. Repeat cesarean was strongly associated with EPH. Clinical characteristics of sepsis-related EPH compared unfavorably with those of hemorrhage-related EPH.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85066894865&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31055843
U2 - 10.1002/ijgo.12837
DO - 10.1002/ijgo.12837
M3 - Article
VL - 146
SP - 103
EP - 109
JO - International Journal of Gynaecology and Obstetrics
JF - International Journal of Gynaecology and Obstetrics
SN - 0020-7292
IS - 1
ER -