Evaluating the management outcomes of gynaecological emergencies at a tertiary hospital, Abakaliki Southeast, Nigeria
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240122Keywords:
Gynaecological, Emergencies, Pregnancy and miscarriageAbstract
Background: Gynaecological emergencies are common causes of emergency hospital presentation/admission. Majority of the emergencies are mostly pregnancy related and pose threat to two lives as well as the women’s future reproductive careers. There is therefore need to evaluate them to make better preparations in managing them.
Methods: This was a 10 year (from 01 January 2012 to 31 December 2021) retrospective study of gynaecological emergencies managed at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AEFUTHA), evaluating their management and outcomes.
Results: The commonest cause of gynaecological emergency at AEFUTHA was miscarriage accounting for up to 69.1% out of which incomplete miscarriage contributed 70.8% and majority had manual vacuum aspiration with good outcome. Ruptured ectopic pregnancies were the commonest surgical emergencies with the incidence of 7.1% and all had laparotomy and partial salpingectomy. Gestational trophoblastic diseases accounted for 2.0% of gynaecological emergencies. The commonest non-pregnancy related gynaecological emergency was acute pelvic inflammatory diseases which accounted for 9.3% of cases. Other gynaecological emergencies reviewed were ovarian accidents (2.9%), abnormal uterine bleeding (3.9%), gynaecological malignancies (2.3%), coital laceration (1.5%), sexual assault (2.4%) and Bartholin’s abscess (0.2%). Factors that affected the outcome were the age of the patients, marital status and disease type and were statistically significant (p<0.05).
Conclusions: Management outcomes of gynaecological emergencies were optimum. Mortality occurred in 1.3% of cases, with gynaecological malignancies accounting for 81.4%. There is usually a good prognosis when prompt, accurate diagnosis and treatment are administered.
References
Takai IU, Omeje IJ. Gynaecological emergencies seen in a referral hospital in North-west Nigeria: a three year retrospective study. Trop J Obstet Gynaecol. 2017;34:152-9.
Buowari D. Pattern and outcome of gynaecological emergencies at a Nigerian secondary health care centre. Int J Trop Med. 2009;6:2.
Fawole AO, Awonuga DO. Gynaecological Emergencies in the tropics: Recent advances in the management. Ann 1b Postgrad Med. 2007;5(1):12-20.
Okafor II, Ugwu IA, Agbo FI. Pattern of gynaecological emergencies in Enugu State University of Scinence and Technology Teaching Hospital, Enugu, Southeast Nigeria. IOSR J Pharm. 2017;7(7):11-6.
Abam DS. Overview of gynaecological emergencies. Intech Open Access. 2015.
Dimejesi IB, Umeora OUJ, Ejikeme B, Eze JN. The Incidence, Pattern and Management Outcomes of Early Pregnancy Losses at the Ebonyi State University Teaching Hospital, Abakaliki. Nigeria J Med. 2010;19(4).
Kilonzo A. The role of Laparoscopy in the management of gynaecological surgical emergencies: A Review of Literature. World J. Lap Surg, 2010;3(3):127-30.
Iyoke CA, Ugwu OG, Ezugwu FO, Onah HE, Agbata AT, Ajah LC. Current approach for assessment and treatment of women with early miscarriages and ectopic pregnancy in Nigeria: A case for dedicated early pregnancy services. Niger J Clin Pract. 2014;17:419-24.
Oguntoyinbo AE Aboyeyi AP. Clinical pattern of gynaecological early pregnancy complaints and the outcome of pelvic sonography in a private diagnostic centre in Ilorin. Nig J Clin Prat. 2011;14:223.
Lawani OL, Anozie OB, Ezeonu PO. Ectopic Pregnancy: a life threatening gynaecological emergency. Int J Women Health. 2013;5:515-21.
Igwegbe AO, Eleje GU, Okpala BC. An Appraisal of the Management of Ectopic Pregnancy in a Nigeria Tertiary Hospital. Ann Med Health Sci Res. 2013;3(2).
Sara HG, Uzelac PS. Early pregnancy risks. In: Decherney AH, Nathan L, Godwin MT, Laufer N, Editors. Current Diagnosis and Treatment: Obstetrics and Gynaecology 10th Ed. Columbus (OH): Mc Graw-HIV. 2007;259-72.
Morgan SR, Long L, Johns J, Angwin C, Maitra S, Ross JJA. Are early pregnancy complications more in women with hyperemesis gravidarum? J Obstet Gynaecol. 2017;37(3):355-7.
Corter JS, Chelmow D, Isaacs CR, Carroll A. Acute care and emergency Gynaecology: A case based approach. Cambridge University Press. 2015;271.
