Clinical and Sociodemographic Characteristics Associated with Emergency Peripartum Hysterectomy due to Puerperal Sepsis in Malawi
DOI:
https://doi.org/10.21106/ijma.535Keywords:
- Cesarean Delivery,
- Emergency Peripartum Hysterectomy,
- Hysterectomy,
- Low-Resource Settings,
- Malawi,
- Maternal Morbidity,
- Maternal Mortality,
- Puerperal Sepsis
Abstract
Background and Objective: In Malawi, emergency peripartum hysterectomy continues to be routine for the management of puerperal sepsis. While the hysterectomy may be life-saving for the mother, it carries with it life-altering permanent sterility. The surgeon is left with a difficult dilemma: remove the infection source (uterus) to preserve the life of the patient at the cost of her fertility, or preserve the uterus and fertility but risk worsening infection and possible death for the patient. The objective of this study was to (1) identify characteristics associated with mortality post-laparotomy due to puerperal sepsis and (2) identify characteristics associated with emergency peripartum hysterectomy in the management of puerperal sepsis.
Methods: In this retrospective chart review, we obtained medical records of patients who underwent laparotomy secondary to puerperal sepsis at a tertiary hospital in Lilongwe, Malawi. Data collected included demographic information and clinical findings. These data were compared between women with and without adverse outcomes. Chi-squared tests were used to determine if there were significant relationships between variables and outcomes.
Results: Fifty-eight patient records met inclusion criteria. The following characteristics were significantly associated with mortality: age greater than 30, multiparity, vaginal delivery, and intensive care unit admission. Cesarean delivery and an intraoperative finding of necrosis were significantly associated with hysterectomy.
Conclusion and Global Health Implications: Emergency peripartum hysterectomy in the setting of puerperal sepsis is a significant source of maternal morbidity and mortality. To prevent emergency peripartum hysterectomy, it is important to have prompt recognition and treatment of puerperal sepsis, to have access to adequate antibiotics, and to have standards to guide the role of hysterectomy as the definitive and necessary treatment for puerperal sepsis.
Downloads
Most read articles by the same author(s)
- Zenab I. Yusuf, Deepa Dongarwar, Rafeek A Yusuf, Meishon Bell, Toi Harris Harris, Hamisu M. Salihu, Social Determinants of Overweight and Obesity Among Children in the United States , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. 1 (2020): International Journal of Maternal and Child Health and AIDS
- Amina Abdullahi, Hassan Adam Murtala, Aisha Adam Abdullahi, Amina Aminu, Muktar H. Aliyu, Sani H. Aliyu, Ololade D. Adeyemi, Deepa Dongarwar, Jordi B. Torrelles, Gambo Aliyu, Hamisu M. Salihu, Drivers of Human Immunodeficiency Virus among Pregnant Women in Conflict and Non-conflict Zones of Nigeria , International Journal of Maternal and Child Health and AIDS: Vol. 14 No. Continuous (2025): International Journal of Maternal and Child Health and AIDS
- Chioma A. Ikedionwu, Deepa Dongarwar, Courtney Williams, Evelyn Odeh, Maylis Peguy Nkeng Peh, Hilliary Hooker, Stacey Wiseman, Tramauni Brock, Erinn Payne-Green, Chidinma Chukwudum, Grace Loudd, Andrea Shelton, Jonnae O. Atkinson, Kiara K. Spooner, Jason L. Salemi, Hamisu M. Salihu, Omonike A. Olaleye, Trends and Risk Factors for Leishmaniasis among Reproductive Aged Women in the United States , International Journal of Maternal and Child Health and AIDS: Vol. 10 No. 2 (2021): International Journal of Maternal and Child Health and AIDS
- Devon Madelyn Rupley, Deepa Dongarwar, Hamisu M. Salihu, Allison M. Janda, Rachel Pope, Healthcare Access as a Risk-Marker for Obstetric Vesicovaginal Fistula in Malawi , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. 1 (2020): International Journal of Maternal and Child Health and AIDS
- Chioma A Ikedionwu, Deepa Dongarwar, Korede K. Yusuf, Sitratullah O. Maiyegun, Sahra Ibrahimi, Hamisu M. Salihu, Using Nominal Group Technique to Elucidate a COVID-19 Research Agenda for Maternal and Child Health (MCH) Populations , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. 3 (2020): International Journal of Maternal and Child Health and AIDS
- Hamisu M. Salih, Deepa Dongarwar, Muktar H. Aliyu, Romuladus E. Azuine, Global Ranking of COVID-19-Related Mortality by Country using a Novel Pandemic Efficiency Index (PEI) , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. 2 (2020): International Journal of Maternal and Child Health and AIDS
- Hadiza Galadanci, Deepa Dongarwar, Wolfgang Künzel, Oladapo Shittu, Murtala Yusuf, Sadiq Abdurrahman, Dolapo Lufadeju, Hamisu M. Salihu, Cesarean Section and Maternal-fetal Mortality Rates in Nigeria: An Ecological Lens into the Last Decade , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. 1 (2020): International Journal of Maternal and Child Health and AIDS
- Veronica B. Ajewole-Mwema, Nkechi U. Ogboh, Dolores Ramirez, Olanike A. Shamonda, Kassie L. Thompson, Sneha George, Deepa Dongarwar, Polly Niravath, Mobile Mammography Outreach in Communities with Unmet Health Needs: Assessment of Appointment Outcomes and Operational Insights from Texas, United States , International Journal of Maternal and Child Health and AIDS: Vol. 14 No. Continuous (2025): International Journal of Maternal and Child Health and AIDS
- Maria Vigil-Mallette, Daryle Pickens, Julliet Ogu, Deepa Dongarwar, Elizabeth Onugha, Hamisu M Salihu, Fifth Annual Summer Research Summit on Health Equity Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on May 17, 2022 , International Journal of Maternal and Child Health and AIDS: Vol. 11 No. S2 (2022): International Journal of Maternal and Child Health and AIDS
- Hamisu M. Salihu, Deepa Dongarwar, Toi B. Harris, Third Annual Summer Research Summit on Health Equity Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on June 9, 2020: ABSTRACT: Advancing Health Equity Through Innovation , International Journal of Maternal and Child Health and AIDS: Vol. 9 No. S3 (2020): International Journal of Maternal and Child Health and AIDS
Similar Articles
- Devon Madelyn Rupley, Deepa Dongarwar, Hamisu M. Salihu, Allison M. Janda, Rachel Pope, Healthcare Access as a Risk-Marker for Obstetric Vesicovaginal Fistula in Malawi , Vol. 9 No. 1 (2020): International Journal of Maternal and Child Health and AIDS
- Deepa Dongarwar, Morgan Lee, Christo Manikkuttiyil, Hamisu M. Salihu, Association Between Social Determinants of Health Issues and Maternal Obesity Among American Racial/Ethnic Groups , Vol. 12 No. 1 (2023): International Journal of Maternal and Child Health and AIDS
- Deepa Dongarwar, Hamisu M. Salihu, Place of Residence and Inequities in Adverse Pregnancy and Birth Outcomes in India , Vol. 9 No. 1 (2020): International Journal of Maternal and Child Health and AIDS
- Elizabeth Armstrong-Mensah, David-Praise Ebiringa, Kaleb Whitfield, Jake Coldiron, Genital Chlamydia Trachomatis Infection: Prevalence, Risk Factors and Adverse Pregnancy and Birth Outcomes in Children and Women in sub-Saharan Africa , Vol. 10 No. 2 (2021): International Journal of Maternal and Child Health and AIDS
- Abdallah Ibrahim, Anne Marie O’Keefe, Do Infant Birth Outcomes Vary Among Mothers With and Without Health Insurance Coverage in Sub-Saharan Africa? Findings from the National Health Insurance and Cash and Carry Eras in Ghana, West Africa , Vol. 2 No. 2 (2014): International Journal of Maternal and Child Health and AIDS
- Danladi Abubakar, Yetunde B. Aremu-Kasumu, Musa Yakubu, Olaniyi T. Fasanu, Sophia O. Baidoo-Adeiza, Birth Preparedness and Complication Readiness among Antenatal Attendees in a Tertiary Hospital in Northern Nigeria , Vol. 13 No. Continuous (2024): International Journal of Maternal and Child Health and AIDS
- Ajibola Idowu, Samson Ayo Deji, Olatayo Ayodele Aremu, Olumuyiwa Matthew Bojuwoye, Akinyemi David Ofakunrin, Birth Preparedness and Complication Readiness among Women Attending Antenatal Clinics in Ogbomoso, South West, Nigeria , Vol. 4 No. 1 (2015): International Journal of Maternal and Child Health and AIDS
- Nidhi Fotedar, Nugehally Raju Ramesh Masthi, Burden of Fetal Anomalies among Antenatal Mothers Attending a Public Referral Hospital: A Mixed Cohort Study , Vol. 14 No. Continuous (2025): International Journal of Maternal and Child Health and AIDS
- Phillips Edomwonyi Obasohan, Paul Gana, Mahmud A. Mustapha, Ahmed Egbako Umar, Audu Makada, Dorcas Nike Obasohan, Decision Making Autonomy and Maternal Healthcare Utilization among Nigerian Women , Vol. 8 No. 1 (2019): International Journal of Maternal and Child Health and AIDS
- Alana F. Hairston, Emily A. Bobrow, Christian S. Pitter, Towards the Elimination of Pediatric HIV: Enhancing Maternal, Sexual, and Reproductive Health Services , Vol. 1 No. 1 (2012): International Journal of Maternal and Child Health and AIDS
<< < 4 5 6 7 8 9 10 11 12 13 > >>
You may also start an advanced similarity search for this article.
Published
How to Cite
Issue
Section
License
Copyright © 2022 Mary Stokes, Amber Olson, Clare Algeo, Bakari Rajab, Carolyn Mwalwanda, Deepa Dongarwar, Rachel Pope. Published by Global Health and Education Projects, Inc., USA.
This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , which permits others to remix, transform, and build upon the work non-commercially, provided the original author is credited and the new creations are licensed under the same terms.