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Audit of hysterectomies in a group of private hospitals in Kaduna City, northern Nigeria
Abstract
Objective: To determine the indications for hysterectomy, associated demographic factors, surgical types and associated morbidity and mortality. We also seek to promote the culture of self- auditing in clinical work in Kaduna.
Study Design, Setting and Subjects: A retrospective review of women in who record st of operation was available in some Private hospitals ,in Kaduna, from January 31 , 1996 to June30, 2000.
Result: There was generally poor data keeping in most of the hospitals. There were 47recorded hysterectomies; 42(89.39%) were elective and 5(10.63%) emergency. Forty two (89.36%) were abdominal and 5(10.63%) vaginal; Obstetric indications accounted for only 4.25% of the operations. Four (8.51%) of the operations were performed in the nulliparae. Indications for hysterectomy included, Uterine fibroids 22(46.80%), DUB 7(14.89%), Genital prolapse 4(8.51%), Complications of induced abortions 3(6.38%). Consultant grade Obstetricians performed 42(89.36%) of the operations. Midline abdominal incision was the choice of access in 24(57.14%) of the operations. Only in 23(48.93%) was histological examination of specimens performed. About 30% of the women had blood transfusion and abdominal wound sepsis, primary post operation haemorrhage and fever occurred in 2.12% each. No death was associated with the operation.
Conclusion: The indications for hysterectomy are varied and the operation appears to be safe in private hospitals in Kaduna. Quality assurance could be improved by simple supply of operation registers to hospitals.
Keywords: hysterectomy, indications, medical audit, Nigeria
Tropical Journal of Obstetrics and Gynaecology Vol. 22(1) 2005: 16-20
