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

Autor:	Vural T; Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey., Bayraktar B; Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey., Karaca SY; Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey., Golbasi C; Department of Obstetrics and Gynecology, Izmir Tinaztepe University Faculty of Medicine, Turkey., Odabas O; Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey., Taner CE; Department of Obstetrics and Gynecology, University of Health Sciences Tepecik Training and Research Hospital, Turkey.
Jazyk:	angličtina
Zdroj:	Malawi medical journal : the journal of Medical Association of Malawi [Malawi Med J] 2023 Mar; Vol. 35 (1), pp. 31-42.
DOI:	10.4314/mmj.v35i1.7
Abstrakt:	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. (© 2023 The Kamuzu University of Health Sciences and the Medical Association of Malawi.)
Databáze:	MEDLINE
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