Objective: To identify the risk factors and study the incidence, indications and complications of emergency peripartum hysterectomy (EPH).
Materials And Methods: This was a retrospective case-control study. The cases consisted of all women who underwent EPH between January 1983 and January 2011. Two controls per case were randomly selected from the remaining deliveries by using a random number table. Case records were retrieved from the medical records.
Results: Among 150,993 deliveries, there were 59 EPHs (cases), giving a rate of 0.390 per 1,000. Of the 59 cases, only 56 were analysed because 3 files were unavailable. These women were older (mean age 36 ± 5.7 vs. 22 ± 5.3 years, p < 0.01) and had delivered more than 1 child (p = 0.02). Thirty-seven (66%) cases had had previous caesarean sections (CSs) and the number of CSs in this group was greater than in the controls (21%, p < 0.01). More index cases had a history of atonic postpartum haemorrhage (46 vs. 4%, p < 0.001) and placenta praevia (34 vs. 4%, p < 0.01). More cases than controls were delivered by CS (73 vs. 29%; p = 0.003). The leading indications for EPH were haemorrhage due to uterine atony and placenta praevia. Independent risk factors were older age, multiparity, history of one or more CSs and placenta praevia. There were 2 maternal deaths from coagulopathy following massive obstetric haemorrhage. The main complications of EPH were febrile morbidity: 12 (21%), wound infection: 8 (14%) and bladder or ureteric injury: 8 (14%).
Conclusions: CSs, especially repeat CSs in women with placenta praevia and persistent uterine atony, significantly increased the risks of peripartum hysterectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000334575 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk Factors for Antepartum Haemorrhage in Women With Placenta Praevia.
Aust N Z J Obstet Gynaecol
January 2025
Obstetrics and Gynaecology, Mater Mothers Hospital, Brisbane, Queensland, Australia.
Background: Placenta praevia (PP) is a significant obstetric complication associated with antepartum haemorrhage (APH) and adverse maternal and fetal outcomes. Identifying risk factors for APH in women with PP is important for guiding management decisions.
Aims: This study aimed to identify risk factors associated with APH amongst women admitted to a single tertiary hospital with PP.
Lessons learned from a case of placenta previa totalis complicated by placenta accreta spectrum: Importance of timely decision-making.
Int J Surg Case Rep
December 2024
Department of Obstetrics and Gynecology, Tishreen University, Lattakia, Syria.
Introduction And Clinical Importance: Placenta previa (PP) is characterized by abnormal placental placement in the lower uterine segment, obstructing the cervical opening. Placenta previa totalis (PPT) occurs when the placenta completely covers the internal cervical os. This condition can lead to placenta accreta spectrum (PAS), where the placenta adheres abnormally to the uterine wall, complicating separation.
View Article and Find Full Text PDFProportion of foetal and placental implantation abnormalities in Madagascar: A cross-sectional study of 35,919 women at public-sector primary healthcare facilities in central and southern Madagascar, 2017-2020.
PLoS One
December 2024
Doctors for Madagascar, Antananarivo, Madagascar.
Background: Like other countries in sub-Saharan Africa, Madagascar has a high burden of maternal and neonatal mortality. However, as the proportion of foetal and placental abnormalities among the Malagasy population is unknown, strategies aimed at reducing maternal and neonatal mortality are challenging to define and implement.
Methods: We conducted a multi-year, cross-sectional study using secondary NGO data on obstetric ultrasound, including patient records of all pregnant women who received an obstetric ultrasound screening between July 1st, 2017, and September 30th, 2020, at 62 public-sector primary care facilities in urban and rural regions of Madagascar.
Prevalence and risk factors associated with birth asphyxia among neonates delivered in China: a systematic review and meta-analysis.
BMC Pediatr
December 2024
Department of Nursing, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
Background: Birth asphyxia is a critical condition caused by an insufficient oxygen supply during delivery, and it poses a major threat to the health of newborns. The present meta-analysis aimed to estimate the prevalence of birth asphyxia among neonates and identify its risk factors in China.
Methods: PubMed, EMBASE, Scopus, Web of Science, the China Academic Journals (CNKI), the Chinese Biomedical Literature (CBM), the China Science and Technology Journal Database (VIP), and the WanFang database were searched for related publications.
PAS or Not PAS? The Sonographic Assessment of Placenta Accreta Spectrum Disorders and the Clinical Validation of a New Diagnostic and Prognostic Scoring System.
J Imaging
December 2024
Obstetrics and Gynaecology Unit, Department of Interdisciplinary Medicine (DIM), University of Bari, 70124 Bari, Italy.
This study aimed to evaluate our center's experience in diagnosing and managing placenta accreta spectrum (PAS) in a high-risk population, focusing on prenatal ultrasound features associated with PAS severity and maternal outcomes. We conducted a retrospective analysis of 102 high-risk patients with confirmed placenta previa who delivered at our center between 2018 and 2023. Patients underwent transabdominal and transvaginal ultrasound scans, assessing typical sonographic features.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!