A Nigerian doctor, Dr. Chidi Ochu Uzoma Esike of Alex Ekwueme Federal University Teaching Hospital, Abakakliki in Ebonyi State has found a new way of stopping women who started having uncontrollable life-threatening bleeding after delivering their babies from bleeding to death. The final treatment to keep such women alive before now was to remove the wombs of such women. But the new technique developed by Dr Esike called ESIKE’S TECHNIQUE preserves the women’s wombs in addition to effectively stopping the bleeding.
The new method, the ESIKE’S TECHNIQUE was published in the most recent edition of the highly respected OBSTETRICS AND GYNECOLOGY the official journal of the American College of Obstetricians and Gynecologists volume 136 number 3 of August 2020.
Dr Esike, a native of Isuikwuato in Abia state and a consultant Obstetrican Gynaecologist who works at the Alex Ekwueme Federal University Teaching Hospital in Abakaliki and also lectures at the Department of Obstetrics and Gynaecology, Faculty of Clinical Medicine, College of Health Sciences of Ebonyi State University, Abakaliki devised the Esike’s technique in 2009 at the Ebonyi State University Teaching Hospital, Abakaliki, Ebonyi.
Between 2009 and 2018, the Esike’s Technique had been used to treat uncontrollable life-threatening bleeding in 18 women who started bleeding uncontrollably after delivering their babies and bleeding was successfully stopped with this technique in 16 of these women with the preservation of their wombs. This gives the technique 89 percent success rate in stopping uncontrollable bleeding in women after delivery and preserving their wombs.
At the point Esike’s technique was used in these women, the only option of treatment left to control their bleeding was the removal of their wombs which is called hysterectomy in medicine. What this meant was that if the Esike’s technique was not used on these women, all the 16 women that had this Esike’s technique would have lost their wombs even if the bleeding was successfully stopped. The fact that Esike’s technique preserves the womb of the woman in addition to stopping the bleeding is a very important advantage of the technique because there is hardly any woman who goes to deliver her baby and bargains that she will lose her womb in the process especially if such a woman has not finished having babies.
Uncontrollable bleeding in women after childbirth called postpartum haemorrhage (PPH) in Medicine is the greatest pregnancy-related killer of women all over the world but this is worse in poor developing countries like Nigeria with their weak health infrastructure and other factors. Unfortunately, it is in these developing countries that young women of reproductive age die in their numbers from bleeding after delivery. This is most painful because such women die for carrying out their God-given duty of replenishing mankind.
It is estimated that every year, about 14 million women around the world suffer from excessive bleeding after childbirth. The World Health Organization estimates that about 60% of death of mothers that occur during pregnancy in developing countries are due to excessive bleeding after delivery (postpartum haemorrhage, PPH for short) and this accounts for more than 100,000 maternal deaths (death of mothers ) per year. It is estimated that every four (4) minutes, one woman dies of bleeding occurring after child birth.
Despite all the efforts by health workers to control excessive bleeding after childbirth, it is estimated that the occurrence of excessive bleeding after child birth is rising, studies having found that the rate of excessive bleeding after delivery rose from 1.5% in 1999 to 4.1% in 2009.
Unfortunately, most of these deaths from excessive bleeding after childbirth (PPH) estimated at 99% of all the PPH occur in low and middle income countries like Nigeria with only the remaining 1% occurring in the industrialized countries.
Health workers however are not relenting in their efforts to fight excessive bleeding in women after childbirth. However, in spite of all these efforts to prevent excessive bleeding after delivery about, 3% to 16.5% of women still go on to experience excessive bleeding after childbirth and will go on to have treatment. This treatment goes on from simple ones like the use of drugs to some procedures and maneuvers to the complex operation of removing the womb (called hysterectomy in medicine) as the final treatment.
Though hysterectomy (removal of the womb) is effective in controlling excessive bleeding after child birth (PPH), it has its complications. It is a complex operation that only specialist and experienced doctors trained on how to perform it can carry out. These doctors are very few in developing countries and most often are concentrated in the cities. This has made us to lose a lot of mothers who had excessive bleeding after childbirth in our numerous villages in the hinterland where the vast majority of these women dwell because the few less experienced medical doctors that deliver the women or whom these bleeding women are brought to cannot perform this complex operation of removal of the womb.
Again removal of the womb makes it impossible for the woman to get pregnant and have babies again. This makes life very miserable for women who have not completed their family size before removal of their wombs. So many women have had their wombs removed just after one pregnancy because they had excessive bleeding after their first and only childbirth. Of importance also is that the womb is the symbol of feminity and fertility for the African woman so removing it for any reason causes a lot of psychological problems. Also of note is that some important structures surrounding the womb can, and actually also get damaged during the complex operation to remove the womb (hysterectomy).
It is against this background that Doctors and other health personnel especially those involved in the care and delivery of women are very excited about the Esike’s Technique that effectively controls the bleeding and also preserves the womb. In addition to the technique being effective, it is simple, easy to teach, easy to learn and most importantly preserves the womb of women with uncontrollable life-threatening bleeding after child birth.
Before being accepted and published in the reputable American journal, the Esike’s technique was thoroughly scrutinized by highly experienced specialist doctors that specialized in the care of women and childbirth called Obstetricians and Gynaecologists in other parts of the world. The Esike’s technique was also compared to other similar methods of controlling bleeding after delivery and was found to be different, unique and to have many advantages over them. For instance it has the advantage of simplicity, being easy to teach to doctors and learnt by them and in its using simple instruments that are used in everyday operations in poor countries. It was also found to be different from other methods.
Esike’s technique had been heralded and haled in the home institutions where it was invented, the Alex Ekwueme University Teaching Hospital Abakaliki and the Ebonyi State University, Abakaliki and also by doctors in Nigeria and in other parts of the world. The Nigerian Medical Association Ebonyi State where Dr Esike was a one-time chairman in their congratulatory message by the Secretary Mr. Chijioke Anyigor Ogah and Chairman Dr. Ben Umezuruike wrote inter alia “We congratulate one of our great teachers, a dependable mentor and one who have served our noble Association in the capacity of Chairman, Dr Chidi Esike on the international recognition of his innovative method of controlling postpartum haemerrhage. We are not unaware of the impact the result of this your creative output will bring not only to the medical profession but humanity in general’.
The Association of Resident Doctors of AE FUTHA under the leadership of Dr Osuagwu David Chidubem in their own felicitation “congratulated Dr. Esike on the innovative Esike’s technique invented here in Alex Ekwueme Federal University Teaching Hospital, Abakaliki which is capable of competing favourably in the international space’.
From faraway United States, Dr. Angela Martin, MD a maternal-fetal medicine specialist at the University Of Kansas Medical Center in Kansas City, United States commenting on the Esike’s technique said, “having quick and effective surgical technique for uncontrolling postpartum haemorrage is essential”. She further stated, ‘I love that Esike’s technique uses polyglatin (vicryl) or chromic sutures. These are familiar to most Surgeons, cheap and typically available even in the most resource deficient settings’.
There is no doubt that Esike’s technique is simple, easy to teach and learn and most importantly effective and preserves the wombs of women having life-threatening bleeding after childbirth and would be of great use in saving many women especially in our resource-constrained countries where many of these cases take place. The greatest challenge now lies in disseminating this great technique and teaching it to doctors especially those in our rural areas who will use it to save the lives of our women. Here in actually lies the challenge of liberating the great potentials of this great Esike’s technique.
