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Tropical Journal of Obstetrics and Gynaecology

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Emergency laparotomy for peripartum haemorrhage in Bida North Central Nigeria

Sunny Abiodun O Ojenuwah, Ruth Olowosulu

Abstract


Context: Despite widespread reports on the incidence and problems of obstetric haemorrhage in developing countries, every tertiary institution must continue to review the problem discuss and advocate preventive measures.

Objective: To assess the predisposing factors and study the surgical management of peripartum haemorrhage in Bida, North Central Nigeria.

Design: Prospective Review of Cases.

Setting: Federal Medical Centre, Bida, Niger State, Nigeria.

Subject: All patients with peripartum haemorrhage (ruptured gravid uterus and uncontrollable post partum haemorrhage) that needed emergency laparotomy between 1 June, 2000 31 May, 2004.

Methods: A detailed history including biosocial and possible predisposing factors to peripartum haemorrhage at presentation were obtained. The indications, findings, type of surgery performed at laparotomy and post operative morbidity/mortality indices were studied.

Results: Most of the patients (92.68%) were unbooked and they all presented in extremis. The post-operative morbidity rate was 81.58%, perinatal mortality was 92.68% while the maternal mortality was 12.20%. There were no statistically significant differences in morbidity and mortality indices in patients who had subtotal hysterectomy and repair of ruptured gravid uterus ± sterilization.

Conclusion: The type of surgery (subtotal hysterectomy or repair of ruptured gravid uterus) performed on these patients does not affect the prognosis. Good antenatal care and adequate labour supervision are still the keys to prevention.

Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 40-43



http://dx.doi.org/10.4314/tjog.v23i1.14564
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