peripartum hysterectomy
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Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 111
Author(s):  
Nicolae Gică ◽  
Carina Ragea ◽  
Radu Botezatu ◽  
Gheorghe Peltecu ◽  
Corina Gică ◽  
...  

Background and Objectives: Emergency peripartum hysterectomy (EPH) is a life-saving surgical procedure performed when medical and surgical conservative measures fail to control postpartum hemorrhage. The objective of this study was to estimate the incidence of EPH and to determine the factors leading to this procedure and the maternal outcomes. Materials and Methods: A retrospective cohort study with all cases of EPH performed at Filantropia Clinical Hospital in Bucharest between January 2012 and May 2021. Results: There were 36 EPH, from a total of 36,099 births recorded. The overall incidence of EPH was 0.99 per 1000 deliveries, most cases being related to placenta accreta spectrum disorder and uterine atony. Conclusions: Peripartum hysterectomy is associated with an important maternal morbidity rate and severe complications. Efforts should be made to reduce the number of unnecessary cesarean deliveries.


Cureus ◽  
2021 ◽  
Author(s):  
Rajlaxmi Mundhra ◽  
Anupama Bahadur ◽  
Shloka Sharma ◽  
Dipesh K Gupta ◽  
Mahima Mahamood M ◽  
...  

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

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Elaine T. Fleming ◽  
Casey S. Yule ◽  
Ashlyn K. Lafferty ◽  
Sarah K. Happe ◽  
Donald D. McIntire ◽  
...  

2021 ◽  
Vol 41 (3) ◽  
pp. 115-115
Author(s):  
A.F. Kallianidis ◽  
A. Maraschini ◽  
J. Danis ◽  
L.B. Colmorn ◽  
C. Deneux-Tharaux ◽  
...  

Author(s):  
Shanti Sah ◽  
Shipra Gupta

Background: Obstetric haemorrhage is a life threatening complication associated with increased maternal morbidity and mortality. Its incidence is 0.2-4 per 1000 deliveries in developed countries and much higher in developing countries. The main cause still remains rupture uterus, postpartum hemorrhage (PPH) and placenta accreta spectrum (PAS).Methods: A retrospective analysis of obstetric hysterectomies performed over a period of 3 years from July 2017 to June 2020 was done. Incidence, risk factors, indication, outcome and complications of obstetric hysterectomies were evaluated.Results: A total 72 cases of obstetric hysterectomy were performed over 3 years period. Out of 72 cases, 33%, 28% and 14% cases were of peripartum hysterectomy done due to rupture uterus, PAS and PPH respectively. There was an increase in the incidence of PAS compared to previous years. There was no observed difference among patients undergoing total or subtotal hysterectomies. No difference as regard to duration of surgery, pre-operative or post-operative hemoglobin, IV fluid and blood product transfusion was noted among elective and emergency procedures. Statistically significant blood loss was observed in emergency hysterectomy compared to elective hysterectomy with p value of 0.004. An average need of transfusions was double in case of peripartum hysterectomy done for PPH compared to rupture uterus or adherent placenta. Bladder injury, burst abdomen and resuturing were three important morbidities. Maternal mortality was 2.8% in our study population.Conclusions: Emergency obstetric hysterectomy still remains a live saving procedure in case of catastrophic intractable hemorrhage and rupture uterus. Proper antenatal supervision, identification of risk factors and timely referral can reduce the incidence of associated morbidity and mortality.


2021 ◽  
Author(s):  
Dawit Sereke ◽  
Habte Hailemelcot ◽  
Ogbaselassie Gebremeskel ◽  
Zeccarais Andemaraim

Abstract Background Emergency peripartum hysterectomy is a life-saving procedure which involves the surgical removal of uterus and is usually performed for uncontrollable maternal haemorrhage when all other conservative management has failed. The aim of this study was to determine the incidence, indication, risk factors and perinatal/maternal outcome related to EPH performed in Mendefera Regional Referral Hospital Methods Case-control study was carried out in women, who underwent EPH over a period of almost 8 years. Controls were women, who had spontaneous vaginal delivery or were delivered by Caesarean section, without EPH. The findings were analyzed using Stata 14. Results During the study period, there were a total of 15,527 deliveries and 31 cases of emergency peripartum hysterectomies, giving an incidence of 2 per1000 deliveries. The mean age, parity, and hospital stay of the cases was 31.5, 4.0 and 5.5 respectively. The main indications for the procedure were uterine atony (38.7%) and uterine rupture (25.8%). Factors showing a significant association with EPH were: being 40 + years of age (OR 10.6; 95%CI 1.5–76.1), being grand multiparous (OR 8.0; 95%CI 2.1–30.4) and CS on the index pregnancy (OR 16.6; 95%CI 7.80-35.95). Subtotal hysterectomy was performed in majority (74%) of cases. The case fatality rate and stillbirth rate was 13% and 34.4% respectively. Conclusion The incidence of EPH in our institution is very high and fetal outcome was poor. The commonest indication for EPH was severe hemorrhages most notably caused by uterine atony or uterine rupture, which are largely preventable.


2021 ◽  
pp. 60-62
Author(s):  
Shree Bharathi ◽  
Niveditha Jha ◽  
Sasirekha Rengaraj ◽  
Veena Ranjan

Morbidly adherent placenta(MAP) is a rare albeit signicant cause of massive obstetric hemorrhage. It occurs as a result of failure of normal decidualisation in the area of a previous uterine scar, which leads to abnormally deep inltration of placental chorionic villi. Early radiological diagnosis in the antenatal period ensures time for adequate preparation for its optimal management by peripartum hysterectomy. A good outcome in these patients depends on a collaborative approach between Obstetricians, Urologists, Intervention Radiologists, Anaesthetists, Transfusion physicians and Neonatologists. In this case report, we present three cases of adherent placenta and their management and outcomes, in our tertiary care setting


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Kasraeian ◽  
Atefe Hashemi ◽  
Kamran Hessami ◽  
Shaghayegh Moradi Alamdarloo ◽  
Razie Vahdani ◽  
...  

Abstract Background We aimed to investigate the risk factors of placenta accreta spectrum (PAS) disorder, management options and maternal and neonatal outcomes of these pregnancies in a resource-limited clinical setting. Methods All women diagnosed with placenta accreta, increta, and percreta who underwent peripartum hysterectomy using a multidisciplinary approach in a tertiary center in Shiraz, southern Iran between January 2015 until October 2019 were included in this retrospective cohort study. Maternal variables, such as estimated blood loss, transfusion requirements and ICU admission, as well as neonatal variables such as, Apgar score, NICU admission and birthweight, were among the primary outcomes of this study. Results A total number of 198 pregnancies underwent peripartum hysterectomy due to PAS during the study period, of whom163 pregnancies had antenatal diagnosis of PAS. The mean gestational age at the time of diagnosis was 26 weeks, the mean intra-operative blood loss was 2446 ml, and an average of 2 packs of red blood cells were transfused intra-operatively. Fifteen percent of women had surgical complications with bladder injuries being the most common complication. Furthermore, 113 neonates of PAS group were admitted to NICU due to prematurity of which 15 (7.6%) died in neonatal period. Conclusion Our findings showed that PAS pregnancies managed in a resource-limited setting in Southern Iran have both maternal and neonatal outcomes comparable to those in developed countries, which is hypothesized to be due to high rate of antenatal diagnosis (86.3%) and multidisciplinary approach used for the management of pregnancies with PAS.


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