Emergency Postpartum Hysterectomy for Uncontrolled Postpartum Bleeding

Rossi, A. Cristina; Lee, Richard H.; Chmait, Ramen H.

doi:10.1097/aog.0b013e3181cfc007

Cited by 209 publications

(65 citation statements)

References 36 publications

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“…The rough incidence of peripartum hysterectomy described here, approximately 0.09%, is slightly higher than the rate of hysterectomy for the general obstetric population, which ranges from 0.04 to 0.08% [4,5,6]. The absence of maternal mortality (none in 59 cases) corresponds well with one study of peripartum hysterectomy but is lower than the 0.6 and the 3.6% rates found in other studies [4,5,6,7]. Beyond the need for blood transfusion – which is generally required by the antecedent maternal hemorrhage – peripartum hysterectomy by itself is not associated with high morbidity.…”

Section: Discussionmentioning

confidence: 38%

Uterine Intravascular Fetal Material and Coagulopathy at Peripartum Hysterectomy

Benson

Cheema²,

Kaufman³

et al. 2012

Gynecol Obstet Invest

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Background/Aims: To test the hypothesis that obstetrical disseminated intravascular coagulopathy results from an excessive leakage of fetal material into the maternal circulation. Methods: All peripartum hysterectomy cases for hemorrhage at two suburban Illinois hospitals over 10 years were included. Intravascular presence of fetal material was determined by two pathologists blinded to each other and to any clinical information. For a given diagnosis, the percentage of intravascular fetal material in those patients with the diagnosis was compared with those without that diagnosis using Fisher’s exact test. Results: Seven diagnoses were attributed to the etiology of the hemorrhage: uterine rupture, abruption, uterine atony, placenta previa, accreta, coagulopathy, and retained placenta. Each of these diagnostic categories had fetal material present – ranging from 20 to 33%, but there were no statically significant differences. Secondary outcome measures of morbidity demonstrated that blood transfusion and intraoperative bladder injury were the chief comorbidities of peripartum hysterectomy. Conclusion: Maternal intravascular fetal material at the time of peripartum hysterectomy is present in up to one third of patients and does not invariably result in disseminated intravascular coagulopathy.

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Section: Discussionmentioning

confidence: 38%

Uterine Intravascular Fetal Material and Coagulopathy at Peripartum Hysterectomy

Benson

Cheema²,

Kaufman³

et al. 2012

Gynecol Obstet Invest

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show abstract

“…A subtotal hysterectomy is thought to be technically easier and associated with shorter operating time, less blood loss, less urological injury and low morbidity [16,19,20]. It is therefore preferred in situations where maternal instability mandates a more expeditious procedure [19,20]. Moreover in developing countries where homologous blood is often not available, pelvic pathologies are extensive and clinical presentation of patients is worse, subtotal hysterectomy may be preferred [4,5,9].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Obstetric Hysterectomy Performed at N’Djamena Mother and Child Hospital (Chad): Indications and Prognosis

Lhagadang¹

2016

OGIJ

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Results FrequencyDuring the study period 29,490 patients were delivered at N'Djamena Mother and child hospital. A total of 46 obstetrics hysterectomies were performed, 11(24%) followed vaginal delivery, 29 (63%) during the course of, or following a caesarean section, and 6(13%) in the postpartum period. The frequency of obstetric hysterectomy was 0.16% of all deliveries (i.e., 1.6 obstetric hysterectomies for 1000 deliveries) ( Table 1).The age group between 30-34 years was the most represented with 41.3%. The average age was 31.2 years, with the extremes ranging from 15 to 44 years. Twenty six patients (56.5%) were not schooled. Parity ranged from 1-13, with a mean of 6.2 ± Research ArticleObstet Gynecol Int J 2016, 4(1): 00095 AbstractBackground: Obstetric hysterectomy is a life saving procedure in severe obstetrical hemorrhage.Objective: Determine its frequency, indications and prognosis. Patients and methods:This was a retrospective and descriptive survey performed at the department of Obstetrics and Gynecology, of N'Djamena Mother and Child Hospital. All patients who had undergone obstetric hysterectomy during the four-year study period from April 2011 to April 2015 were studied.Results: During the study period, 29,490 patients were delivered at N'Djamena Mother and child hospital. A total of 46 obstetrics hysterectomies were performed that give a frequency of 0.16%. The average age was 31.2 years, with the extremes ranging from 15 to 44 years. Parity ranged from 1-13 with 41.7% of grand multipara. The commonest cause of obstetric hysterectomy was ruptured uterus, seen in 29 (63%) patients. Uterine atony was responsible in 10 (21.7%) cases. In 91.3% of the cases (n=42) subtotal hysterectomy was performed and in others total hysterectomy was performed (8.7%). Main maternal complications were: sepsis (6.5%) and urological injuries (6.5%). Maternal outcome was enameled by three deaths giving a lethality rate of 6.5%. Fetal prognosis was worst with a fetal death rate of 69.5%. Conclusion:Obstetric hysterectomy remains frequent in our regions. Adequate prenatal consultation and surveillance of patients during labor are required for curbing the frequency of obstetric hysterectomy.

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“…Plasenta invazyon anomalisi günümüzde postpartum histerektominin en s›k endikasyonunu oluflturmaktad›r (3) . Plasenta invazyon anomalisi nedeniyle yap›lan histerektominin morbidite ve mortalitesi di¤er endikasyonlara göre çok daha fazla olmaktad›r.…”

Section: G‹r‹fiunclassified

Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

Kalelioğlu¹,

Esmer²,

Has³

et al. 2013

J Turk Soc Obstet Gynecol

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Emergency Postpartum Hysterectomy for Uncontrolled Postpartum Bleeding

Abstract: Women at highest risk of emergency hysterectomy are those who are multiparous, had a cesarean delivery in either a previous or the present pregnancy, or had abnormal placentation.

Cited by 209 publications

References 36 publications

Uterine Intravascular Fetal Material and Coagulopathy at Peripartum Hysterectomy

Uterine Intravascular Fetal Material and Coagulopathy at Peripartum Hysterectomy

Obstetric Hysterectomy Performed at N’Djamena Mother and Child Hospital (Chad): Indications and Prognosis

Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

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