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Emergency peripartum hysterectomy in a tertiary obstetric center: nine years evaluation.
MedLine Citation:
PMID:  21481094     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims:  The aim of this study was to estimate the incidence, indications, risk factors, complications, and maternal morbidity and mortality associated with obstetric hysterectomy performed at the Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital between January 2000 and January 2008. Material & Methods:  A retrospective study of patients requiring an emergency peripartum hysterectomy (EPH) over a 9-year period was conducted. Emergent peripartum hysterectomy was defined as an operation performed in cases whose bleeding was not prevented by other approaches for 24 h after delivery. Thirty-nine cases of emergency peripartum hysterectomy were performed. Results:  The incidence of emergency peripartum hysterectomy was 0.37 per 1000 deliveries. Thirty-four cases of hysterectomy were performed after cesarean section (CS). The main indication for EPH was placenta accreta (53.8%), followed by uterine atony (25.6%). There were six maternal deaths (15.4%). Severe maternal morbidity included: bladder injury (15.4%), relaparotomy (35.4%), and transfusion >10 unit's red blood cells (15.6%). Both previous CS and CS in the index pregnancy were associated with a significant increased risk of EPH. The number of previous CS was related to an increased risk of placenta accreta; the relative ratio increased from 3.6 for one previous CS to 37 for three or more previous CS. Conclusion:  Emergency peripartum hysterectomy is significantly related to CS in index or previous pregnancy. Placenta accreta is the most common indication to perform peripartum hysterectomy. EPH is associated with a high incidence of maternal morbidity and mortality.
Authors:
Oya Demirci; Ahmet S Tuğrul; Ertuğrul Yılmaz; Ozgür Tosun; Elif Demirci; Yadigar S Eren
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-12
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  -     ISSN:  1341-8076     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
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