Korean J Perinatol.  2008 Sep;19(3):262-268.

A study on the clinical characteristics of emergency peripartum hysterectomy

Affiliations
  • 1Department of Obstetrics and Gynecology Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, Korea. phwon45@daum.net

Abstract


OBJECTIVE
To investigate the clinical characteristics and associated risk factors for emergency peripartum hysterectomy classified by the amounts of blood loss. MATERIAL AND METHODS: We reviewed the medical records of 159 cases of peripartum hysterectomy among 46,666 deliveries, from Jan. 1995 to Dec. 2005 at the Dept. of Ob. & Gy. of Graduate School of Medicine, Gachon University of Medicine and Science. We divided the 159 cases into three groups based on the amounts of blood loss, which were group A as less than 2,000 mL of blood loss, group B as 2,000 to 4,000 mL of blood loss, and group C as more than 4,000 mL. The incidence, the type of delivery, the amounts of transfusion, the operative indication and the complications of peripartum hysterectomy were evaluated.
RESULTS
The incidence of peripartum hysterectomy was 0.34% (159/46,666) and 0.47% in cases of cesarean section and 0.19% in vaginal delivery, respectively. There was no meaningful correlation between maternal age, parity, gestational age, hospital stay and amount of blood loss. The increments of blood loss correlated to the frequency of peripartum hysterectomy after cesarean section (p<0.05). The most common operative indication in group A was uterine atony (47.19%), and those in group B and C were adherent placentation (48.08%, 50.00%). Intraoperative and postoperative complications according to excessive bleeding were increased, and DIC, pulmonary infection, urethral and bladder injury were observed more frequently in group C than in group A.
CONCLUSION
The emergency peripartum hysterectomy was related to adherent placentation and was accompanied with increased blood loss.

Keyword

Emergency peripartum hysterectomy; Adherent placentation; Amount of blood loss

MeSH Terms

Cesarean Section
Dacarbazine
Emergencies
Female
Gestational Age
Hemorrhage
Humans
Hysterectomy
Incidence
Length of Stay
Maternal Age
Medical Records
Parity
Peripartum Period
Placentation
Postoperative Complications
Pregnancy
Risk Factors
Urinary Bladder
Uterine Inertia
Dacarbazine
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