Emergency peripartum hysterectomy in the nulliparous patient

Abstract Objective To find out the incidence, indications and outcomes of emergency peripartum hysterectomy in the nulliparous woman. Method Retrospective study at the Korle Bu Teaching Hospital in Accra, Ghana, between January 1995 and December 2003. Results During the eight-year study period there were 92,966 deliveries out of which 36,550 (39.5%) were for the nulliparous. Peripartum hysterectomy was performed for 39 nulliparous women, thus giving an incidence of 1 per 1000 nulliparous deliveries. The indications for the hysterectomy were: atonic uterus 28 (71.8%), ruptured uterus 8 (20.5%) and placenta praevia/accreta 3 (7.7%). The perinatal losses were 8 (20.5%) and the total blood loss ranged from 1 to 4.5 l. There were no maternal deaths but there were 7 near-missed fatalities. Conclusion Though rare, peripartum hysterectomy in the nulliparous patients carries high maternal morbidity and perinatal mortality.