Mortality and morbidity after emergency peripartum hysterectomy in a provincial referral hospital in Papua New Guinea: A seven‐year audit

• DOI: 10.1111/ajo.13286
• Publication Date: 2020-12-22T18:16:08Z
• Authors: John W. Bolnga; Glen D. L. Mola; Paula Ao; Wendy Sapau; Ovoi Verave; Elvin Lufele; Moses Laman
• Keywords: New guinea

Emergency peripartum hysterectomy (EPH) is a life-saving surgical procedure performed at the time of caesarean section or within 24 h vaginal delivery and usually last resort in obstetric haemorrhage when other interventions fail.To investigate incidence, indications, risk factors complications EPH provincial referral hospital Papua New Guinea (PNG).This was seven-year retrospective observational study investigating rate between January 2012 December 2018. Patient medical records that included socio-demographics, factors, indications for maternal perinatal outcomes were reviewed.Of 19 215 deliveries during period, 26 women had EPH, giving an incidence 1.35 per 1000 deliveries. The majority (18/26) referred from peripheral health facilities. Overall, 21 survived five died (mortality index, 19%). Uterine rupture most common indication (13/26), it associated with high death 15.4% (2/13) significantly higher deaths compared to babies born mothers (13/13 (100%) versus 5/13 (38.5%); P = 0.002). Neonates uterine atony more likely survive (8/11 (72.7%) 0/15 (0%); < 0.001), although mortality 27.3% (3/11).Uterine after prolonged labour are significant mortality. Improving pre-hospital management remains critical PNG.