[Emergency obstetrical hysterectomy: about 58 cases at Libreville Hospital Centre]. / L'hystérectomie obstétricale d'urgence. A propos de 58 cas au Centre hospitalier de Libreville.

OBJECTIVE: To evaluate the incidence, indications and prognosis of this surgery in our daily practice in order to suggest preventive action. PATIENTS AND METHOD: This is a retrospective study over a period of 10 years, from January 1, 1992 to December 31, 2001. Using patient's documents, parameters have been analysed as followed: age, parity, antecedent of uterine surgery, indications, surgery technique, foeto-maternal prognosis. RESULTS: The frequency of this intervention is 0.07%. The average age of patients was 31 years and the average parity was 6. The indications were: 44 cases of haemorrage (76%) and 14 cases of post-abortum infection (24%). Sub-total hysterectomy was performed on all the patients. We have observed 14 cases of maternal death (24%) and 24 cases of foetal death (57%). CONCLUSION: The frequency of this surgery is weak in our daily practice, compared with other Black African countries. But foeto-maternal prognosis is severe. A better sensibilisation of the population on prenatal consultations benefits and the setting up of a real national strategy of obstetrical emergency care constitute a means to prevent this type of surgery.