An audit of peripartum hysterectomies at Groote Schuur hospital, 2014 -2019

Adjei, Alfred

An audit of peripartum hysterectomies at Groote Schuur hospital, 2014 -2019

Thesis / Dissertation

2024

Publisher

University of Cape Town

Department

Department of Obstetrics and Gynaecology

Faculty

Faculty of Health Sciences

Abstract

BACKGROUND Peripartum hysterectomy is a major surgical procedure performed in the se ng of life-threatening haemorrhage and uterine sepsis unresponsive to conserva ve measures. The opera on is considered one of the major interven ons in obstetrics and carries high maternal morbidity and mortality, mostly due to the reasons for which it is done. An audit of peripartum hysterectomies was performed at Groote Schuur Hospital during 1999-2003, which showed the main indica ons were uterine sepsis and obstetric haemorrhage. The problem of uterine sepsis was at a me when there was a high rate of HIV infec on with no treatment available for mothers.The introduc on of an retrovirals for pregnant women was commenced in the Western Cape in 2001 with the use of single dose Nevirapine during labour or prior to caesarean sec on. Currently, all pregnant women living with HIV are immediately provided with lifelong treatment regardless of CD4 count and adherence reinforced during the antenatal visits. It is thus of interest to repeat this audit twenty years later to evaluate if there is any difference in indica ons and outcomes. OBJECTIVES 1.To determine the incidence, indica ons, and complica ons associated with peripartum hysterectomy at Groote Schuur Hospital (GSH), New Somerset Hospital (NSH) and Mowbray Maternity Hospital (MMH) 2. To compare study results with a similar study conducted between 1999 to 2003 at Groote Schuur Hospital METHODOLOGY A retrospec ve descrip ve audit of peripartum hysterectomies was performed at GSH, NSH AND MMH for the years 2015-2019. Peripartum hysterectomy was defined as hysterectomy performed within 24 hours of delivery or within the same hospital admission or within 6 weeks of delivery. Pa ents who had peripartum hysterectomies during this period were iden fied from the labour ward and gynaecology theatre register, and data retrieved from their files. All sta s cal analysis was performed by using SPSS version 27.0.0.0 (IBM, Armonk, NY, USA).

Keywords

MA

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