Incidence of Emergency Peripartum Hysterectomy in a Tertiary Obstetrics Unit in Romania

Gică, Nicolae; Ragea, Carina; Botezatu, Radu; Peltecu, Gheorghe; Panaitescu, Anca Maria

doi:10.3390/medicina58010111

Cited by 11 publications

(17 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the literature, the frequency of emergency obstetric hysterectomy varies from one region to another; indeed, if it has become exceptional in developed countries, it most often remains the last possible life-saving gesture for mothers in under-medicalized countries [2][3][4]. African studies have reported varying incidences: Sy T in Guinea (0.16%), Nayama in Niger (1.35%) and Abidi (1.3%) in Tunisia [5,6,7] while in developed countries the frequency is relatively low and varied between 0.52‰ to 1.07‰ of deliveries [8][9]. In developing countries, neglect or inaccessibility to prenatal care, ignorance of risk factors and danger signs of pregnancy, socio-economic factors and delays in early access to care expose women to often fatal hemorrhagic complications [2].…”

Section: Discussionmentioning

confidence: 99%

“…This observation is made in our study with maximum obstetric hysterectomies in women in the age group of 30 to 34 years 33% (n = 33) and multiparas 72% (n = 72). Multiparity was found in many other African studies [5-10-11], in fact multiparity weakens the myometrium, thus favoring ruptures and uterine inertia [1][2][3][4][5][6][7][8][9][10][11][12]. Quality prenatal monitoring can detect certain factors early and take action (hypertension blood pressure in pregnancy, scarred uterus, surgical bedpans, and defective presentations) [13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of emergency hysterectomies at Zinder mother and child health center (CSME)

Garba¹,

Z²,

Nabara³

et al. 2023

Magna Sci. Adv. Res. Rev.

View full text Add to dashboard Cite

Introduction: Emergency obstetric hysterectomy is a life-saving surgery performed as a last resort in the face of a serious accident during parturition. The objective is to describe the risk factors, the indications, the types of hysterectomy performed and their complications encountered. Patients and methods: To achieve our objectives, we carried out a retrospective study from January 1, 2016 to December 31, 2018. Were included, patients who underwent a hysterectomy of obstetric origin at the CSME of Zinder. Results the study focused on 100 cases of obstetric hysterectomy recorded out of 10,124 deliveries, i.e. a frequency of 0.98%. The age of our patients varied between 16 years for the youngest and 45 for the oldest with an average of 30.5 years. They were uneducated in 84% of cases, mostly multiparous 72%, 71% of whom lived in rural areas. Pregnancy was not continued in 81%. The main indications were uterine rupture, uterine atony and PRH in 68%, 16% and 14% respectively. The hysterectomy was total in 41% and subtotal in 59%. Maternal morbidity was dominated by anemia with 84.2%. Perinatal and maternal mortality were respectively 76.69% and 9%. Conclusion: Obstetric hysterectomy is frequent at the CSME of Zinder, all ages were concerned, and they were mostly multiparous, with the deadliest obstetric complications. Maternal and perinatal morbidity and mortality were very high.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of emergency hysterectomies at Zinder mother and child health center (CSME)

Garba¹,

Z²,

Nabara³

et al. 2023

Magna Sci. Adv. Res. Rev.

View full text Add to dashboard Cite

show abstract

“…Although time‐trend analysis showed a decreasing tendency for the CS rate after 2017, it was still much higher than the WHO recommendations 13 . The CS rate and prior number of CS operations are strongly associated with the occurrence of AP 11,12,14 . Additionally, studies have shown that the risk of PH dramatically increases in pregnant women with complications of PP and or PAS and with prior cesarean deliveries 14–17 .…”

Section: Discussionmentioning

confidence: 99%

Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Wang,

Zhang

2023

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveTo explore the change trends in incidence and leading factors to peripartum hysterectomy (PH) at a regional tertiary medical center in northeast China.MethodsThis was a retrospective observational study of all PH cases conducted at Shengjing Hospital between January 1, 2012 and December 31, 2021. Information on maternal characteristics of pregnancy and delivery, indications of PH, inventions before hysterectomy, complications, and maternal and neonatal outcomes obtained from the Shengjing Hospital Information System were analyzed.ResultsAmong a total of 157 553 deliveries, there were 127 cases of PH (overall PH incidence: 0.85/1000 deliveries); 120 patients (94.49%) underwent hysterectomy after cesarean section, and seven (5.51%) underwent vaginal delivery (P < 0.001). Abnormal placentation was the leading indication for PH (101, 79.53%), including placenta previa (PP) with placenta accreta spectrum (PAS) (93, 73.23%), PP alone (5, 3.94%), and PAS alone (3, 2.36%). Among the patients who underwent PH with abnormal placentation, 92.08% had at least one cesarean section (P < 0.001) and 20.19% had bladder injury (P = 0.044). All maternal deaths (n = 2) occurred in referral patients, and the maternal mortality rate was 1.57/100 hysterectomies.ConclusionAbnormal placentation was the primary indication for PH. For such patients, adequate assessment of their condition and complete communication are strongly recommended. The identification of high‐risk groups for postpartum hemorrhage, timely and effective rescue, and referral are equally important for avoiding PH.

show abstract

“…A question that needs to be answered when offering the option of EM when treating PAS is related to the risks of complications and need for a subsequent HT. Furthermore, women managed expectantly should be informed that they require long-term follow-up, with multiple hospital visits for blood tests and ultrasounds ( Figure 1 ) and immediate access to health care facilities [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Risk of Subsequent Hysterectomy after Expectant Management in the Treatment of Placenta Accreta Spectrum Disorders

et al. 2022

Self Cite

View full text Add to dashboard Cite

Management strategies for pregnancies with abnormal adherence/invasion of the placenta (placenta accreta spectrum, PAS) vary between centers. Expectant management (EM), defined as leaving the placenta in situ after the delivery of the baby, until its complete decomposition and elimination, has become a potential option for PAS disorders in selected cases, in which the risk of Caesarean hysterectomy is very high. However, expectant management has its own risks and complications. The aim of this study was to describe the rates of subsequent hysterectomy (HT) in patients that underwent EM for the treatment of PAS disorders. We reviewed the literature on the subject and found 12 studies reporting cases of HT after initial intended EM. The studies included 1918 pregnant women diagnosed with PAS, of whom 518 (27.1%) underwent EM. Out of these, 121 (33.2%) required subsequent HT in the 12 months following delivery. The rates of HT after initial EM were very different between the studies, ranging from 0 to 85.7%, reflecting the different characteristics of the patients and different institutional management protocols. Prospective multicenter studies, in which the inclusion criteria and management strategies would be uniform, are needed to better understand the role EM might play in the treatment of PAS disorders.

show abstract

Incidence of Emergency Peripartum Hysterectomy in a Tertiary Obstetrics Unit in Romania

Cited by 11 publications

References 29 publications

Analysis of emergency hysterectomies at Zinder mother and child health center (CSME)

Analysis of emergency hysterectomies at Zinder mother and child health center (CSME)

Reflections on peripartum hysterectomy: A 10‐year retrospective observational study in Northeast China

Risk of Subsequent Hysterectomy after Expectant Management in the Treatment of Placenta Accreta Spectrum Disorders

Contact Info

Product

Resources

About