Indications, risk factors, and outcomes of emergency peripartum hysterectomy: A 7-year retrospective study at a tertiary center in Turkey.

IF 1.2 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Tayfun Vural, Burak Bayraktar, Suna Yildirim Karaca, Ceren Golbasi, Ozan Odabas, Cuneyt Eftal Taner
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引用次数: 0

Abstract

Objective: To determine the incidence, indications, the risk factors, complications, maternal morbidity and mortality of emergency peripartum hysterectomy (EPH), and perinatal outcomes at a tertiary hospital, Turkey.

Methods: We analyzed 71 cases of EPH from 2012 to 2019 at a tertiary hospital in a retrospective study. There were 142 control patients.

Results: There were 71 EPH out of 69,504 deliveries, for an overall incidence of 1.02 per 1000 births. The main indication for peripartum hysterectomy was abnormal placentation (67.6%), followed by uterine atony (28.1%), and uterine rupture (4.2%). Cesarean section (CS) and previous CS are major risk indicators for EPH. Other risk indicators are advanced maternal age (≥ 35 years) and multiparity. All patients with abnormal placentation had a previous CS. 93% of EPH were performed during and/or after CS, and 7% after vaginal delivery. 69% of EPH were made in total and 31% were subtotal. The three most common maternal morbidity included: wound infection and febrile morbidity (26.7%), bladder injury (16.9%), and disseminated intravascular coagulopathy (11.2%). There were no maternal deaths but perinatal mortality was 4%.

Conclusion: The most common indication for EPH was abnormal placentation. Also, CS and previous CS are major risk factors of EPH. Other risk factors for EPH are advanced maternal age (≥ 35 years) and multiparity. Moreover, all unnecessary CS should be avoided.

紧急围产期子宫切除术的适应症、危险因素和结果:土耳其一家三级中心的7年回顾性研究
目的确定土耳其一家三级医院急诊围产期子宫切除术(EPH)的发生率、指征、危险因素、并发症、孕产妇发病率和死亡率以及围产期结局。对照组142例。结果69504例分娩中有71例EPH,总发生率为1.02/1000。围产期子宫切除术的主要指征是胎盘形成异常(67.6%),其次是子宫无力(28.1%)和子宫破裂(4.2%)。剖宫产和既往剖宫产是EPH的主要风险指标。其他风险指标是高龄产妇(≥35岁)和多胎性。所有胎盘形成异常的患者均既往有CS。93%的EPH在CS期间和/或之后进行,7%在阴道分娩后进行。总EPH占69%,小计占31%。三种最常见的产妇发病率包括:伤口感染和发热(26.7%)、膀胱损伤(16.9%)和弥漫性血管内凝血病(11.2%)。没有产妇死亡,但围产期死亡率为4%。结论EPH最常见的指征是胎盘形成异常。此外,CS和既往CS是EPH的主要危险因素。EPH的其他危险因素是高龄产妇(≥35岁)和多胎性。此外,应避免所有不必要的CS。
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来源期刊
Malawi Medical Journal
Malawi Medical Journal Medicine-General Medicine
CiteScore
1.50
自引率
0.00%
发文量
27
审稿时长
>12 weeks
期刊介绍: Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region. Topics covered in the journal include, but are not limited to: - Communicable diseases (HIV and AIDS, Malaria, TB, etc.) - Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.) - Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.) - Mental health - Environmental health - Nutrition - Health systems and health policy (Leadership, ethics, and governance) - Community systems strengthening research - Injury, trauma, and surgical disorders
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