Incidence, Indications, and Predictors of Adverse Outcomes of Postpartum Hysterectomies: 20-Year Experience in a Tertiary Care Centre

Ibrahim, Marina; Ziegler, Cleve; Klam, Stephanie; Wieczorek, Paul; Abenhaim, Haim A.

doi:10.1016/s1701-2163(15)30679-4

Cited by 19 publications

(12 citation statements)

References 31 publications

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“…The objective of uterine cavity tamponade is twofold: to treat PPH (i.e., to achieve definitive haemostasis) and as a “bridging” measure (i.e., to achieve temporary haemostasis and haemodynamic stabilisation and allow other measures [surgical or interventional radiology] to be put in place) 62 , 63 , 64 . In addition to other second-line treatment strategies, uterine tamponade can significantly reduce the rate of emergency hysterectomies 65 , 66 .…”

Section: Guidelinementioning

confidence: 99%

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

Schlembach

Helmer

Henrich

et al. 2018

Geburtshilfe Frauenheilkd

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Purpose This is an official interdisciplinary guideline, published and coordinated by the German Society of Gynaecology and Obstetrics (DGGG), the Austrian Society of Gynaecology and Obstetrics (OEGGG) and the Swiss Society of Gynaecology and Obstetrics (SGGG). The guideline was developed for use in German-speaking countries and is backed by the German Society of Anaesthesiology and Intensive Medicine (DGAI), the Society of Thrombosis and Haemostasis Research (GTH) and the German Association of Midwives. The aim is to provide a consensus-based overview of the diagnosis and management of peripartum bleeding obtained from an evaluation of the relevant literature. Methods This S2k guideline was developed from the structured consensus of representative members of the various professional associations and professions commissioned by the Guideline Commission of the DGGG. Recommendations The guideline encompasses recommendations on definitions, risk stratification, prevention and management.

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Section: Guidelinementioning

confidence: 99%

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

Schlembach

Helmer

Henrich

et al. 2018

Geburtshilfe Frauenheilkd

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“…Nineteen patients (41.3%) were in the age group of 30 to 34years and twenty two (41.7%) were grand multipara .High association with multiparty was seen by previous studies [3][4][5][6]12,14,15]. Other risk factors for Emergency peripartum hysterectomy (EPH), like previous cesarean birth, obstructed labor, current cesarean delivery, and abnormal placental implantation and invasion, were similar to the literature [1,2,12,13].…”

Section: Discussionmentioning

confidence: 91%

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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“…However, due to an increasing primary caesarean delivery (CD) rate and a decline in the number of facilities offering trial of labor after CD, the rate of CD remains adequate at 32.8% for sufficient procedural learning. Meanwhile, obstetric patients' age and medical morbidities increased, raising the potential for intrapartum obstetric emergencies such as abruptio placentae that require rapid team response [6][7][8][9][10]. These facts are consistent with an increase in the average number of cesarean sections per ObGyn resident from 191.8 in 2002-2003 to 233.4 in 2012-2013, while volumes of vaginal, forceps, and vacuum deliveries, and amniocentesis decreased [11].…”

Section: Introductionmentioning

confidence: 78%

Surgical Skills Simulation Center Implementation: Healthcare Continuous Quality Improvement Project

Nwanodi¹

2017

Health Sci J

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In the United States, upon resident work hour restriction implementation, obstetrics and gynaecology residents' gynaecologic surgery volume decreased and operative time per caesarean delivery increased. High volume surgeons can have clinically significantly lower complication rates than low volume surgeons, p<0.001. Decreasing surgical volumes and increasing operative time raise the question of procedural patient safety in teaching institutions. Some institutions are turning to international rotations in resource-limited nations to increase residents' surgery volume, possibly doubling monthly surgical volume. As resource-limited nations need to train and increase their indigenous health care workforce, surgical skills simulation is ethically preferable to training high-resource nation residents in resourcelimited nations. A medical and surgical skills simulation center (SSSC) implementation is a workplace continuous quality improvement (CQI) project that can benefit multiple facility departments and community organizations. Stakeholder preparedness must be evaluated before embarking on a CQI project. Anonymous brainstorming contributes to CQI project selection. There is a preferred strategy for incorporating a SSSC into an obstetrics and gynecology department. Staff, space, systems, supplies, science, success, support, and sustainability will come into play at different stages of SSSC implementation. Once operational, the SSSC must undergo CQI to optimize effectiveness. Continuous quality improvement plan-do-study-act cycles are recommended at least as frequently as equipment upgrades.

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Incidence, Indications, and Predictors of Adverse Outcomes of Postpartum Hysterectomies: 20-Year Experience in a Tertiary Care Centre

Cited by 19 publications

References 31 publications

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016)

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

Surgical Skills Simulation Center Implementation: Healthcare Continuous Quality Improvement Project

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