This study was conducted to investigate the risk factors associated with peripartum hysterectomy in women who had either vaginal or cesarean delivery. The study subjects were women (n ϭ 101) who had a peripartum hysterectomy at the authors' institution from January 1986 to April 2001. Seventy-two of the 101 patients had delivered at Yonsei University Medical Center and 29 were referred from other hospitals. Of the total 31,044 deliveries at Yonsei during this time period, 11,924 were performed by cesarean section. Fifty-four of these women (0.45%) and 28 of the 19,080 who had a vaginal delivery (0.09%) underwent peripartum hysterectomy. Five of the 29 referred patients had a cesarean section and 24 had a vaginal delivery. The average time from delivery to hysterectomy was significantly longer in the vaginal group than in the cesarean section group (169 min vs. 49 min; P Ͻ.05). Also, women who had a vaginal delivery required significantly more blood (1908 ml) than those who had a cesarean section (1536 ml)(P Ͻ.05), although the average length of hospital stay was similar for both groups. Uterine atony was the most common indication for peripartum hysterectomy (42 of 101; 41.6%). Placenta previa accreta, placenta accreta, and placenta previa was the diagnosis in 23.8%, 16.7% and 11.9% of patients, respectively. Among the 29 women who had a previous cesarean section, the indications were uterine atony (n ϭ 10; 34.5%), placenta previa accreta (n ϭ 13; 44.8%), placenta previa (n ϭ 4; 13.8%), and placenta accreta (n ϭ 2; 6.9%). Blood loss was more highly associated with placenta previa accreta than with placenta previa or accreta alone (1734 ml vs. 16,58 ml and 1084 ml, respectively; P Ͻ.05). The only complications recorded were bladder injury in one woman with placenta previa, one disseminated intravascular coagulopathy in the placenta accreta group, and one case of sepsis among patients with placenta previa accreta. Of the 59 peripartum hysterectomies associated with cesarean section, 26 were in women undergoing elective cesarean section (44.1%) and 33 were after emergency cesarean section (55.9%). Blood loss was similar in both groups. The women who had emergency surgery experienced a higher complication rate than those undergoing elective cesarean section. Two patients sustained bladder injury, one had ureteral injury, one had bowel injury, one developed acute hepatitis, and one had disseminated intravascular coagulopathy. In the elective surgery group, there was a bladder laceration in one patient and another patient had disseminated intravascular coagulopathy. GYNECOLOGYVolume 58, Number 7 OBSTETRICAL AND GYNECOLOGICAL SURVEY ABSTRACT This paper presents the results of an investigation of the force required to insert a laparoscopic trocar into the abdominal cavity. Both disposable and reusable laparoscopic trocar systems were studied. Study subjects were 20 consecutive women who were scheduled to undergo routine diagnostic and laparoscopic surgery and were randomly selected for either the disposable trocar device...
The prevalence of urinary symptoms associated with benign prostatic hyperplasia was studied in a community-based, nationwide, representative sample of 2,011 French men 50 to 80 years old. Symptoms were assessed by the American Urological Association symptom index. After exclusion of patients with prostate cancer, 6.9% of the subjects reported having undergone prostate surgery. Among the surgery-free subjects, nocturia and repeat voiding within 2 hours were the most prevalent symptoms. Based on the American Urological Association symptom index, 18.8% of the men were considered free of urinary symptoms, and 67%, 13% and 1.2%, respectively, ranked between 1 and 7, 8 and 19, and 20 or more. The proportion of men scoring greater than 7 approximately doubled with each decade of age. Our estimation indicated that in 1992 approximately 1.14 million French men had moderate to severe urinary symptoms that were likely to be associated with benign prostatic hyperplasia. Previous studies had yielded higher prevalence estimates, probably due to differences in sampling design and diagnostic criteria.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.