Gynaecological emergencies seen in a referral hospital in Northwest Nigeria: A 3-year retrospective study

Abstract

Background : Gynaecological emergencies are common causes of morbidity and mortality worldwide and patients’ characteristics are important determinants of gynaecological emergencies. Objectives : This study was conducted to determine the pattern and management outcome of gynaecological emergencies in Aminu Kano Teaching Hospital (AKTH), Kano. Materials and Methods : A 3‑year retrospective review of all gynaecological emergencies seen in AKTH between January 2012 and December 2014 was done. Results : A total of 3050 gynaecological consultations were done within the period under review, 1337 of which were gynaecological emergencies giving an institutional prevalence of 43.8%. The highest (44.5%) frequency was seen in the 21–30‑year age group. Ten different types of gynaecological emergencies were seen with abortion being the leading (59.3%) gynaecological emergency. Incomplete abortion is the most common form of miscarriage in age’s ≥ 20 years; in the Parous; and amongst married women. Sexual assault occurred in 5% of the patients, with 47.8% occurring in individuals aged below 10 years. The least common gynaecological emergency was coital laceration which accounted for 0.5%. The prevalence of mortality from gynaecological emergencies was 3.7%. The most common cause of mortality from a gynaecological emergency was bleeding gynaecological malignancy and carcinoma of the cervix accounting for 41.2%. Conclusion : Gynaecological emergencies are common and abortions are the most common emergency at AKTH. Patient characteristics play a significant role in their pattern of presentation, while outcomes of these emergencies are related to their cause and manner of presentation. Increased surveillance and advocacy of policies that strongly punish individuals convicted of sexual assault should be encouraged, and increased awareness and utilization of Pap smear should be encouraged for early detection of premalignant and early stage carcinoma of the cervix. Further research is required to identify the possible risk factors/causes of abortion in this environment. Key words: Aminu Kano Teaching Hospital; gynaecological emergency; pattern; review.