AI Article Synopsis
- A study at the Riyadh Armed Forces Hospital from 1990 to 1997 documented 54,166 deliveries, of which 6119 (11.3%) were caesarean sections, and noted a rare occurrence of emergency peripartum hysterectomy for severe obstetric hemorrhage in 16 cases (0.3/1000 deliveries).
- The majority of hysterectomies were due to placenta praevia (75%) and a smaller portion due to atonic postpartum hemorrhage (25%), with all patients needing blood transfusions and a recorded neonatal death but no maternal fatalities.
- Key findings highlight the risk factors for hysterectomy related to scarred uterus conditions, emphasizing the importance of experienced obstetric
Article Abstract
A total of 54 166 mothers delivered at the Riyadh Armed Forces Hospital between 1990 and 1997, including 6119 (11.3%) caesarean sections. Emergency peripartum hysterectomy for obstetric haemorrhage was carried out in 16 cases (0.3/1000 deliveries). The operation followed major degrees of placenta praevia in 12 (75%) cases and atonic postpartum haemorrhage in four (25%). All patients required blood transfusion. There was one neonatal death and no maternal deaths. Although the operation was straightforward, bladder injury occurred in five (31%) cases which was repaired with no residual damage. Placenta accreta was confirmed histologically in 12 (75%) patients. In conclusion, all obstetricians should be aware of the strong association between a scarred uterus, placenta praevia and placenta accreta which can be very adherent and difficult to remove causing bleeding and necessitating hysterectomy. The operation should be performed by an experienced obstetrician before the patient's condition is extreme.
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| http://dx.doi.org/10.1080/01443619866264 | DOI Listing |
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