scholarly journals Emergency peripartum hysterectomy: Five-year experience in a university hospital

2021 ◽  
Vol 5 (11) ◽  
pp. 1086-1089
Author(s):  
Feyza BAYRAM ◽  
Canan URUN ◽  
Jale KARAKAYA ◽  
Süleyman Serkan KARAŞİN
Keyword(s):  
University Hospital ◽  
Peripartum Hysterectomy ◽  
Emergency Peripartum Hysterectomy

scholarly journals Emergency peripartum hysterectomy in a tertiary hospital in Antananarivo, Madagascar

2018 ◽  
Vol 7 (11) ◽  
pp. 4752
Author(s):  
Ratsiatosika A. Tanjona ◽  
Randriamahavonjy Romuald ◽  
Ratongasoa Mahefa ◽  
Housni I. A. ◽  
Rakotonirina A. Martial ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Tertiary Hospital ◽  
Uterine Atony ◽  
University Hospital ◽  
Maternal Complications ◽  
Peripartum Hysterectomy ◽  
Third Stage ◽  
Emergency Peripartum Hysterectomy ◽  
Delivery Route ◽  
Epidemiological Profile

Background: Postpartum hemorrhage is one of the leading causes of maternal death in the entire world. It affects 10% of deliveries. Emergency peripartum hysterectomy (EPH)defined as a lifesaving procedure involving the removal of the uterus to treat severe postpartum hemorrhage is one of the last-resort treatments for severe postpartum hemorrhage in case of failure of other techniques. Through this study, we aimed both to describe the epidemiological profile, to determine the etiologies, and maternal complications of EPH.Methods: It is about a descriptive retrospective study from January 1st, 2016 to January 1st, 2017 at the Befelatanana University Hospital of Obstetrics and Gynecology. We included all patients who underwent Emergency peripartum hysterectomy after 22 weeks of Amenorrhea (WA) regardless of the delivery route in the centre. We used the R software for the statistical analysis of the results.Results: We had 31 cases of EPH during this period with a prevalence of 0.44%. The average age was 26.38±5.61 years. Mean gestational age was 37±3.59 weeks of amenorrhea. In the 83.87% of cases, the patient received less than four prenatal consultations. Patients were referred in 45.16% of the cases. The delivery route was by cesarean section in 48.39% of cases. Eleven patients (35.48%) received a blood transfusion. Hysterectomy was subtotal in 96.77% of the cases. We had five (16.13%) maternal deaths during the study period. The leading cause of death was hemorrhagic shock (80%). The etiology of hysterectomy was dominated by uterine atony complicated by hemorrhage (48.39%), followed by retroplacental hematoma (25.81%) and uterine rupture (22.58%).Conclusions: EPH still holds its place in the management of postpartum hemorrhage in Madagascar. Maternal mortality remains high. Uterine atony was the most common indication for EPH. The prevention of postpartum hemorrhage by management of the third stage of labour should be carried out by any health actor.

scholarly journals Emergency peripartum hysterectomy in a tertiary teaching hospital in Northern Jordan: a 15-year review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hasan Rawashdeh ◽  
Rawan Obeidat ◽  
Lubna Masaadeh
Keyword(s):  
Cesarean Section ◽  
Statistical Significance ◽  
University Hospital ◽  
Peripartum Hysterectomy ◽  
Adherent Placenta ◽  
Subtotal Hysterectomy ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Significant Difference ◽  
Emergency Peripartum Hysterectomy

AbstractEmergency peripartum hysterectomy is a major operation performed when conservative measures fail to stop life-threatening postpartum hemorrhage. It is associated with a high rate of maternal morbidity among survivors. This work aims to evaluate the incidence, indication, and complications of peripartum hysterectomy at King Abdulla University Hospital over 15 years. A retrospective cohort study of emergency peripartum hysterectomy. The incidence was calculated. Risk factors for abnormally adherent placenta were explored. A comparison between total and subtotal hysterectomy in terms of morbidity outcomes was conducted. The chi-square test, Fisher’s exact, and independent sample T test were used for analysis. Statistical significance was declared at α < 0.05. The incidence of peripartum hysterectomy was 1.38 per 1000 births. Fifty-nine were performed after cesarean section and three were performed after vaginal delivery (P<0.001). Abnormally adherent placenta (accreta, increta, and percreta) was the main indication (44.06%). The strongest risk factor for abnormally adherent placenta was placenta previa with previous cesarean section (P=0.001, OR 16.25, 95% CI 1.95-135.01). One maternal and three neonatal deaths were recorded. Urinary bladder injury was the most frequent complication (27.11%). No difference in morbidity was noted between total and subtotal hysterectomy. The incidence of emergency peripartum hysterectomy is increasing steadily over the last two decades in the north of Jordan. Abnormally adherent placenta is the most common indication for emergency peripartum hysterectomy. There is no significant difference between total and subtotal hysterectomy in terms of complications’ development, admission to the intensive care unit, and estimated blood loss. The morbidity associated with emergency peripartum hysterectomy is significant.

scholarly journals Emergency peripartum hysterectomy in a tertiary teaching hospital in Northern Jordan: a 15-year review

2020 ◽  
Author(s):  
Hasan Rawashdeh ◽  
Rawan Obeidat ◽  
Lubna Masaadeh
Keyword(s):  
Caesarean Section ◽  
Statistical Significance ◽  
University Hospital ◽  
Abnormal Placentation ◽  
Peripartum Hysterectomy ◽  
Subtotal Hysterectomy ◽  
Estimated Blood Loss ◽  
Tertiary Teaching ◽  
Significant Difference ◽  
Emergency Peripartum Hysterectomy

Abstract Background Emergency Peripartum hysterectomy is a major operation performed when conservative measures fail to stop life-threatening postpartum haemorrhage. It is associated with a high rate of maternal morbidity among survivors. The aim of this work is to evaluate the incidence, indication, and complications of peripartum hysterectomy at King Abdulla University Hospital over a 15-year period. Methods A retrospective cohort study of emergency peripartum hysterectomy. The incidence was calculated. Risk factors for abnormal placentation were explored. A comparison between total and subtotal hysterectomy in terms of morbidity outcomes was conducted. The Chi-square test, Fisher’s exact and Independent Sample T-Test were used for analysis. Statistical significance was declared at α < 0.05. Results The incidence of peripartum hysterectomy was 1.46 per 1000 births. Sixty-three were performed after caesarean section and three were performed after vaginal delivery (P < 0.001). Abnormal placentation (accreta, increta and percreta) was the main indication (46.03%). The strongest risk factor for abnormal placentation was placenta previa with previous caesarean section (P < 0.001, OR 17.33, 95% CI 2.09–143.14). One maternal and three neonatal deaths were recorded. Urinary bladder injury was the most frequent complication (26.98%). No difference in morbidity noted between total and subtotal hysterectomy. Conclusions The incidence of emergency peripartum hysterectomy in increasing steadily over the last two decades in the north of Jordan. Abnormal placentation is the commonest indication for emergency peripartum hysterectomy. There is no significant difference between total and subtotal hysterectomy in terms of complications` development, admission to the ICU, and estimated blood loss. The morbidity associated with emergency peripartum hysterectomy is significant.

scholarly journals Emergency peripartum hysterectomy at Jordan University hospital – a teaching hospital experience

2020 ◽  
Vol 19 (2) ◽  
pp. 66-71
Author(s):  
Ayman Qatawneh ◽  
Kamil Fram ◽  
Fida Thikerallah ◽  
Nadia Mhidat ◽  
Farah Fram ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
University Hospital ◽  
Peripartum Hysterectomy ◽  
Hospital Experience ◽  
Emergency Peripartum Hysterectomy

scholarly journals Emergency Peripartum Hysterectomy: 20-Year Experience of a University Hospital

2017 ◽  
Vol 3 (3) ◽  
pp. 165-169
Author(s):  
Melih VELİPAŞAOĞLU ◽  
Metin ŞENTÜRK ◽  
H.Mete TANIR
Keyword(s):  
University Hospital ◽  
Peripartum Hysterectomy ◽  
Emergency Peripartum Hysterectomy

Clinical Audit of Obstetrical Hysterectomies for a Period of One Year in A Tertiary Care Hospital

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Farzana Latif ◽  
Sadia Ilyas ◽  
Saeed Mehmood ◽  
Hammad Arif ◽  
Nuzhat Parveen Khawaja ◽  
...  
Keyword(s):  
Gestational Age ◽  
Tertiary Care Hospital ◽  
Clinical Audit ◽  
Tertiary Care ◽  
Care Hospital ◽  
Hospital Record ◽  
Record System ◽  
Peripartum Hysterectomy ◽  
Emergency Peripartum Hysterectomy ◽  
One Year

Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus. Key Words: Uterine artery embolization, Emergency peripartum hysterectomy, maternal morbidity and mortality, healthcare providers How to Cite: Latif F, Ilyas S, Mehmood S. Arif H. Khawaja P. Nuzhat. Jawad Z. J Clinical audit of obstetrical hysterectomies for a period of one year in a tertiary care hospital. Esculapio.2020;16(04):50-53.

scholarly journals Emergency Peripartum Hysterectomy as Postpartum Hemorrhage Treatment: Incidence, Risk factors, and Complications

2014 ◽  
Vol 52 (193) ◽  
pp. 668-676 ◽  
Author(s):  
Meena Pradhan ◽  
Yong Shao
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Placenta Previa ◽  
Uterine Atony ◽  
Previous Caesarean Section ◽  
Peripartum Hysterectomy ◽  
Incidence Risk ◽  
Emergency Peripartum Hysterectomy

Introduction: The aim of the research was to investigate incidence, risk factors, and complications associated with emergency peripartum hysterectomy, the ultimate treatment method for intractable postpartum hemorrhage.Methods: This is a single center case-control study conducted in Chongqing city in central China from 1st January 2007 to 31st December 2012 for emergency peripartum hysterectomy performed as a treatment of postpartum hemorrhage both in caesarean and vaginal delivery cases. While the study group included emergency peripartum hysterectomy (n=61) due to intractable postpartum hemorrhage, the control group included no hysterectomy (n=333) during the same study period.Results: We found 61 cases recorded for emergency peripartum hysterectomy for intractable postpartum hemorrhage. Incidence of peripartum hysterectomy was 2.2 per 1000 deliveries. Emergency peripartum hysterectomy as treatment of intractable postpartum hemorrhage include the followings: (i) blood loss 1000-2000 ml, crude odd ratio (OR) =18.48 (95% CI 5.1-65.7), adjusted odd ratio (AOR) = 9.1 (95% CI 2.2-37.7); (ii) blood loss >2000 ml, OR = 152 (95% CI 43.7-528.4), AOR = 45.3 (95% CI 11.6-176.9); (iii) previous caesarean section, OR = 5.5 (95% CI 2.9-9.7), AOR = 3.7(95% CI 1.4-9.9); (iv) uterine atony, OR = 11.9 (95% CI 5.8-24.6), AOR = 7.5 (95% CI 1.8-30.2); (v) placenta previa, OR = 2.04 (95% CI 1.1-3.5), AOR = none. Conclusions: Emergency peripartum hysterectomy is the last resort as treatment of intractable severe postpartum hemorrhage. Our study depicts that severe post partum hemorrhage, further dreaded complex events for emergency peripartum hysterectomy, has significant association with placental factors, previous caesarean section, and uterine atony. Pathologically, placenta accreta remained the most leading cause of hysterectomy.Keywords: caesarean section; hemorrhage; peripartum hysterectomy; placenta previa.

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