Adiri Charles O¹, Okoro Onyemaechi S^1,, Nwankwo Theophilus O¹, Nnagbo John-paul E¹, Nnaji Henry C¹, Eze Matthew I¹, Agu Polycarp U¹, Achara John I¹, Ifezuoke Dickson T¹, Asimadu Eric E¹, Nkwo Peter O¹

Background: Post partum hemorrhage is an important cause of maternal mortality globally. Emergency peripartum hysterectomy is a life saving surgery performed to control bleeding in patients with post partum hemorrhage in whom all other conventional methods have failed. Previous studies done in our centre over a decade ago, reported higher prevalence of EPH compared to developed world. Objectives: This study was conducted to determine the current prevalence and indications for EPH in our environment. Methods: This was a cross sectional retrospective study of all the patient that had EPH between January 2016 to December 2025 in University of Nigeria Teaching Hospital, Enugu. The demographic data, risk factors, indications and outcome including (blood transfusion, bladder injuries, bowel injuries, febrile morbidity, ICU admission, and maternal mortality, were recorded. Patients who had EPH at delivery or within 24 hours after delivery, and at gestational age of 28 weeks and above were included in the study. All patients who had EPH after 24 hours of delivery or before 28 weeks gestation were excluded. Descriptive statistics were used to analyze the data. Results: A total of 6115 deliveries were recorded during the period of study out of which 22 had EPH, giving a prevalence of 0.36% of all deliveries (3.6/1000 deliveries). Of the 22 EPH recorded, 20(90.9%) were performed for caesarean delivery while 2(9.1%) were performed for vaginal delivery. Majority of the patients belong to the age group 31-40 year (63.64%) and the mean age of patients was 35.4±7.1 years. Of the 22 patients that had EPH, only 8(36.4%) booked for antenatal care in our hospital, while 14(63.6%) were unbooked. Most of the women 16(72.10%) had parity between 1-3. Thirteen women (59.10%) had no previous scar, while 8(36.40%) had only one previous scar. The most common indication for EPH/ was ruptured uterus 8(36.4%), closely followed by uterine atony 7(31.8%). Placenta accreta and presence of multiple uterine fibroids accounted for 6(27.3%) and 1(4.5%) respectively. All the patients that had EPH received blood transfusion, 19(86.36%) had febrile morbidity, 6(27.22%) had ICU admission, 3(13.64%) had bladder injuries, 3(13.64%) had DIC, while 4(18.18%) had bowel injury. Conclusion: The prevalence of EPH is still unacceptably high in our environment, compared to developed countries of the world from this study. Uterine rupture was the most common indication for EPH in this study and most of the patient that had uterine rupture were unbooked patient. Therefore, all measures should be adopted to ensure that all pregnant women book for antenatal care.

EPH, Prevalence, Characteristics, Tertiary, Enugu, Nigeria