Emergency Hysterectomy for Obstetric Hemorrhage

Clark, Steven L.; YEH, SZE-YA; Phelan, Jeffrey P.; Bruce, Samuel L.; Paul, Richard H.

doi:10.1097/00006254-198502000-00010

Cited by 80 publications

(129 citation statements)

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“…12,16 Kodla CS et al identified a hysterectomy rate of 10.31% which was similar to findings of Drief et al 19,22 Regarding maternal outcomes, 25.6% had DIVC, 8.5% developed septicaemia and 6% developed acute renal The most common cause was placenta previa with bleeding and irreversible haemorrhagic shock.…”

Section: Discussionsupporting

confidence: 69%

Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

Padmasekar

Jothy

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Massive obstetric haemorrhage is defined as blood loss of >1500 ml, or a decrease in haemoglobin>4 gm/dl or acute transfusion requirement of >4 units of blood when need for further transfusion is foreseeable. The purpose of this study is to analyse the demographic, medical and obstetric risk factors for massive obstetric haemorrhage and it’s materno fetal outcomes.Methods: Criteria for patient selection was all patients who had an acute obstetric haemorrhage necessitating a transfusion of >4 units of blood at a stretch when there was a need for more. This is a retrospective study conducted for a period of one year January to December 2015. Data regarding all cases under study during this period was obtained from Medical Records Department with prior permission. This study was conducted in the Department of Obstetrics and Gynecology, Government Raja Mirasudhar Teaching Hospital, Thanjavur Medical College, Tamil Nadu. Maternal outcomes like mode of delivery, rate of hysterectomy, postpartum complications, maternal mortality and fetal outcomes like intra uterine death, still birth and preterm birth were analysed.Results: The rate of massive obstetric haemorrhage in our hospital during the study period was 5.7/1000 births. Massive obstetric haemorrhage contributed to 25% of all maternal deaths in 2015. Atonic PPH was the commonest cause. Multiparity and previous caesarean section were identified to be significant risk factors.Conclusions: We found an increased association of massive obstetric haemorrhage with multiparity, caesarean sections and pre-eclampsia. Atonic PPH was the commonest cause. Massive obstetric haemorrhage had contributed significantly to adverse maternal and perinatal outcomes.

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Section: Discussionsupporting

confidence: 69%

Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

Padmasekar

Jothy

2017

Int J Reprod Contracept Obstet Gynecol

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“…4,10 In a study conducted by Clark SL and colleagues uterine atony was the most common indication for peripartum hysterectomy followed by placental abnormalities. 11 In present study 4 cases of placenta accreta were found in previous cesarean cases and 1 had history of curettage in previous pregnancy for missed abortion. Similar results are reported by Umezurike CC and colleagues in Nigeria.…”

Section: Discussionmentioning

confidence: 52%

Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

2016

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of this study was to study indications and the outcome of emergency peripartum hysterectomy for PPH in a tertiary care centre and to study the maternal mortality and morbidity in these patients. Methods: This is an observational study conducted at Vanivilas hospital attached to Bangalore Medical College and Research Institute between January 2014 to December 2015 for 24 months. The women who fulfill the inclusion criteria are studied with respect to parity, gestational age at delivery, route of delivery (vaginal/cesarean), details of instrumental delivery, conservative methods used to control bleeding, ICU admissions and blood transfusions. An analysis of maternal mortality and morbidity was done with respect to development of hypovolemic shock, DIC, anemia, acute kidney injury, septicemia and maternal deaths. Results: The rate of peripartum hysterectomy is 10.1 per 1000 live births. Placental abnormalities (placenta previa and placenta accreta) are the leading indications (41.4%) for peripartum hysterectomy followed by uterine atony (34.5%). All 29 women received blood and blood product transfusions. 34.5% developed febrile morbidity, 27.6% developed DIC, 10.3% developed acute kidney injury and septicemia and 10.3% maternal deaths. Conclusions: PPH is unpredictable in onset, duration and etiology and it remains a major life threatening complication of any delivery. The most common causes of hemorrhage in these women are placental abnormalities and uterine atony. When conservative treatment is not feasible or has failed, prompt peripartum hysterectomy is performed failing which the delay would contribute to the maternal morbidity and mortality.

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“…Clark'ın çalışmasına göre her iki operasyon şeklinde operasyon süresi, kan kaybı ve hastanede yatış süreleri açısından farklılık bulunmamıştır. Bunun yanısıra Clark çalışmasında plasenta yerleşim anomalilerinde tam histerektomiyi önermiştir (17). Çalışmamızda 6 (% 50) hastaya tam histerektomi, 6 (% 50) hastaya da tama yakın histerektomi uygulanmıştır.…”

Section: Gereç Ve Yöntemunclassified

The Efficacy Of Emergency Hysterectomy In Peripartum Vaginal Bleeding

Demirtaş¹,

Terzi²,

Türkay³

et al. 2012

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ÖZETAmaç: Acil peripartum histerektomi olgularının insidansını, endikasyonlarını, risk faktörlerini, annedeki morbidite ve mortalite üzerine etkilerini araştırmak. Gereç ve Yöntem: Kocaeli Derince Eğitim Araştırma hastanesi Kadın Hastalıkları ve Doğum Kliniğinde Temmuz 2006 ileHaziran 2012 tarihleri arasında çeşitli nedenlerle acil peripartum histerektomi uygulanan 12 olgunun; demografik özellikleri, insidansı, ilişkili olduğu risk faktörleri, histerektomi endikasyonları, gelişen komplikasyonlar, anne morbidite ve mortaliteleri geriye dönük incelendi. Bulgular:Altı yıl içinde hastanemizde toplam 12314 doğum gerçekleştirilmiş ve aynı dönemde çeşitli nedenlerle 12 hastaya peripartum histerektomi uygulanmıştır. Acil peripartum histerektomi insidansı % 0,097 olarak hesaplanmıştır. Hastaların ortalama yaşı 31,92 ± 5,48, ortalama gebelik sayıları 3,08 ± 2,19, ortalama doğum sayıları 1,83 ± 0,83 olarak tespit edildi. En sık saptanan endikasyon % 50 oranı ile uterus atonisi olarak belirlendi. Peripartum histerektomilerin 6'sı (% 50)tam, 6'sı (% 50) ise tama yakın(subtotal) uygulandı. Eş zamanlı olarak iki (% 16,7) hastaya hipogastrik arter iki taraflı bağlandı ve bir (% 8,3) hastaya postoperatif karıniçi kanama nedeni ile relaparotomi uygulandı. Bir (% 8,3) hastada tüketim koagülopatisi ve bir (% 8,3) hastada intraoperatif mesane yaralanması izlendi. Anne ölümü izlenmedi.Sonuç: Acil peripartum histerektomilerde başlıca endikasyon uteral atoniye bağlı kontrol edilemeyen kanama olup,yüksek komplikasyon oranına rağmen (%25: 3/12 olgu) mortalite olmamıştır.Anahtar Sözcükler: Doğum, Peripartum histerektomi, Uterin atoni SUMMARY Aim: To investigate the incidence, indications, risk factors, as well as the effects on maternal morbidity and mortality for the emergency peripartum hysterectomy cases performed at our hospital. Material and Method:For the 12 cases that underwent emergency peripartum hysterectomy for various obstetric reasons between July 2006 and June 2012 at the Kocaeli Derince Training and Research Hospital Clinic of Gynecology and Obstetrics, the demographic characteristics, incidence, associated risk factors, indications, complications, maternal morbidity and mortality rates were retrospectively evaluated.

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Emergency Hysterectomy for Obstetric Hemorrhage

Cited by 80 publications

References 0 publications

Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

Retrospective study of massive obstetric haemorrhage and its materno fetal outcomes in a tertiary care centre

Clinical study of emergency peripartum hysterectomy for postpartum hemorrhage

The Efficacy Of Emergency Hysterectomy In Peripartum Vaginal Bleeding

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