Document Detail


Emergency peripartum hysterectomy: experience at a community teaching hospital.
MedLine Citation:
PMID:  12052583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To estimate the incidence, indications, risk factors, and complications associated with emergency peripartum hysterectomy at a community-based academic medical center. METHODS: We analyzed retrospectively 47 of 48 cases of emergency peripartum hysterectomy performed at Winthrop-University Hospital from 1991 to 1997. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment less than 24 hours after delivery. Fisher exact test, Wilcoxon rank sum test, and Cochran-Armitage exact trend test were used for analysis. RESULTS: There were 48 emergency peripartum hysterectomies among 34,241 deliveries for a rate of 1.4 per 1000. Most frequent indications were placenta accreta (48.9%, 12 with previa, 11 without previa), uterine atony (29.8%), previa without accreta (8.5%), and uterine laceration (4.3%). Placenta accreta was the most common indication in multiparous women (58.8%, 20 of 34), uterine atony the most common in primiparas (69.2%, nine of 13). Twenty-two of 23 (95.6%) women with placenta accreta had a previous cesarean delivery or curettage. The number of cesarean deliveries or curettages increased the risk of placenta accreta proportionally. Thirty-eight (80.9%) of the hysterectomies were subtotal. Postoperative febrile morbidity was 34%; other morbidity was 26.3%. CONCLUSION: Placenta accreta has become the most common indication for emergency peripartum hysterectomy.
Authors:
Elana S Kastner; Reinaldo Figueroa; David Garry; Dev Maulik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  99     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-07     Completed Date:  2002-06-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  971-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Winthrop-University Hospital, Mineola, New York 11501, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Emergency Service, Hospital / utilization*
Female
Hospitals, Teaching
Humans
Hysterectomy / utilization*
Incidence
New York / epidemiology
Obstetric Labor Complications / epidemiology*,  surgery
Placenta Accreta / epidemiology,  surgery
Postpartum Hemorrhage / epidemiology,  surgery
Pregnancy
Retrospective Studies
Risk Factors
Comments/Corrections
Comment In:
Obstet Gynecol. 2002 Jun;99(6):967-8   [PMID:  12052581 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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