TITLE:
Emergency Peripartum Hysterectomy in the Far North Region of Cameroon: Prevalence, Indications, and Maternal Outcomes in a Five-Year Retrospective Study
AUTHORS:
Rakya Inna, Clovis Ourtchingh, Ernestine Diana Belinga, Jules Anthony Mbarga, Stéphane Mbarndjuk Aoudi, Chantal Sadia Didjo’o, Souley Salamatou, Isséni Aché, Claude Cyrille Ndoua Noa
KEYWORDS:
Emergency Peripartum Hysterectomy, Uterine Rupture, Maternal Mortality, Postpartum Hemorrhage, Cameroon
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.4,
April
21,
2026
ABSTRACT: Background: Emergency peripartum hysterectomy (EPH) is a life-saving surgical procedure performed when severe obstetric complications cannot be controlled by conservative measures. Although the incidence of this procedure has declined in high-income countries, it remains relatively frequent in low-resource settings and is associated with substantial maternal and perinatal morbidity and mortality. Objective: To determine the prevalence, indications, and maternal outcomes of emergency peripartum hysterectomy at Maroua Regional Hospital in the Far North Region of Cameroon. Methods: We conducted a retrospective descriptive cross-sectional study at Maroua Regional Hospital between January 2020 and December 2024. All women who underwent emergency peripartum hysterectomy during pregnancy, delivery, or the postpartum period were eligible. Data were retrieved from delivery registers, operative reports, and medical records and included sociodemographic characteristics, obstetric factors, surgical indications, and maternal outcomes. Results: During the study period, 12,580 deliveries were recorded, among which 73 emergency peripartum hysterectomies were identified, corresponding to a prevalence of 5.8 per 1000 deliveries. However, complete medical records were available for 43 women, and these cases were included in the detailed analysis. The median age was 30 years, and most women were multiparous. Uterine rupture was the leading indication for hysterectomy (67.4%), followed by uterine atony (16.3%). Subtotal hysterectomy was the most frequently performed procedure (72.1%). Blood transfusion was required in 74.4% of patients. Postoperative complications were recorded in 38% of patients, mainly surgical site infection and postoperative anemia. The maternal mortality rate was 16.3%. Conclusion: Emergency peripartum hysterectomy remains relatively frequent in the Far North Region of Cameroon and is associated with significant maternal morbidity and mortality. Strengthening referral systems, improving intrapartum monitoring, and ensuring timely access to comprehensive emergency obstetric care are essential to reduce preventable maternal deaths.