Emergency obstetric hysterectomy in a university hospital: A 25-year review
- 1 January 2008
- journal article
- obstetric
- Published by Taylor & Francis Ltd in Journal of Obstetrics and Gynaecology
- Vol. 28 (1), 69-72
- https://doi.org/10.1080/01443610701816885
Abstract
Over the past 25 years, 43 peripartum hysterectomies were performed at the authors' institution, an incidence of 0.64/1,000 deliveries; 31 procedures followed caesarean section and 12 were performed for haemorrhage following vaginal delivery. The common indications for hysterectomy were abnormal placentation (39.5%), uterine atony (23.3%), uterine rupture (23.3%), and haemorrhage during caesarean section (11.6%). The risk factors for hysterectomy included advancing maternal age and parity, previous caesarean section scars and abnormal placentation. Subtotal hysterectomy was performed in 72.1% cases which appeared a quicker and safer procedure than total hysterectomy in desperately ill patients. Five (11.6%) maternal deaths occurred in the series. Mortality was associated with massive haemorrhage. With rising caesarean section rates worldwide, MRI and colour Doppler sonography is useful to diagnose antepartum placenta accreta/bladder involvement in order to plan elective surgery that is associated with reduced maternal morbidity and mortality. Early decision to perform an emergency hysterectomy is essential before the patient's condition deteriorates, besides availability of an experienced obstetrician to undertake a technically demanding operation.Keywords
This publication has 14 references indexed in Scilit:
- Obstetric hysterectomy: fifteen years' experience in a Nigerian tertiary centreJournal of Obstetrics and Gynaecology, 2003
- Emergency peripartum hysterectomy: experience at a community teaching hospitalObstetrics & Gynecology, 2002
- Primary postpartum haemorrhageJournal of Obstetrics and Gynaecology, 2002
- High temporal resolution dynamic contrast MRI in a high risk group for placenta accretaMagnetic Resonance Imaging, 2001
- Peripartum hysterectomy in the 1990s: any new lessons?Journal of Obstetrics and Gynaecology, 2001
- Prenatal diagnosis of placenta previa accreta by transabdominal color Doppler ultrasoundUltrasound in Obstetrics & Gynecology, 2000
- MRI appearance of placenta percreta and placenta accretaMagnetic Resonance Imaging, 1999
- Clinical risk factors for placenta previa–placenta accretaAmerican Journal of Obstetrics and Gynecology, 1997
- Emergency peripartum hysterectomy and associated risk factorsAmerican Journal of Obstetrics and Gynecology, 1993
- Emergency Hysterectomy in Obstetrics—a Review of 117 CasesAustralian and New Zealand Journal of Obstetrics and Gynaecology, 1987