Urological lesions in patients undergoing obstetric hysterectomy secondary due to abnormal placental insertion in a high specialty hospital
| Autor: | Carlos R, Jiménez-Vieyra, Alicia, Gómez-Suaste, Juan C, Hinojosa-Cruz, Juan A, García-Bello |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Chi-Square Distribution Cesarean Section Urinary Bladder Placenta Previa Placenta Accreta Middle Aged Hysterectomy Statistics Nonparametric Parity Young Adult Cross-Sectional Studies Pregnancy Risk Factors Humans Female Uterine Hemorrhage Ureter Intraoperative Complications Retrospective Studies |
| Zdroj: | Cirugia y cirujanos. 88(4) |
| ISSN: | 2444-054X |
| Popis: | To describe frequency and identify risk factors for urological lesions in patients undergoing obstetric hysterectomy secondary to abnormal placental insertion in a high specialty hospital.Transversal, retrospective study of patients underwent hysterectomy due to abnormal placental insertion, from 2017 to 2019; age, obstetric antecedents, comorbidities, type of abnormal placental insertion type of hysterectomy, site of urinary lesion, anesthesia, surgery time and bleeding were studied. Analyses were made with ji square and Kruskal Wallis tests with SPSS V20.0 program considering significative p values p0.05.Clinical records of 96 patients with age 32.6 ± 6.1 years were analyzed. Accretism was present in 38.5%, incretism in 19.8% and percretism in 18.8%. Total hysterectomy was accomplished in 78 (81.2%) cases. Urinary lesion was present in 27 (28.1%); vesical in 19 (19.8%), ureteral in 6 (6.5%) and both in 2 (2.0%). Urinary lesion was significantly more frequent in those patients with more pregnancies (median 4 [interquartile range (IQR): 3-4] vs. 3 [2-4]; p= 0.004), more caesarean sections (4 [3-4] vs. 2 [1-3]; p0.001), hemorrhage (3000 mL [2000-4800] vs. 2000 mL [1200-3000]; p = 0.001), and more surgery time (3.75 h [3.5-4.0] vs. 3.0 [2.0-3.5]; p0.001).Urinary lesions in patients undergoing obstetric hysterectomy secondary to abnormal placental insertion are more frequent with higher number of pregnancies, caesarean sections, hemorrhage and surgery time.Identificar los factores de riesgo asociados a lesiones urológicas en pacientes con histerectomía por inserción anómala de placenta.Estudio transversal, retrospectivo, de pacientes sometidas a histerectomía por inserción anómala de placenta de 2017 a 2019. Se estudiaron edad, antecedentes obstétricos, comorbilidad, tipo de inserción placentaria, tipo de histerectomía, sitio de la lesión urinaria, anestesia, tiempo quirúrgico y sangrado. Se realizaron medidas de tendencia central y dispersión, frecuencias y proporciones. Los análisis se realizaron con las pruebas de ji al cuadrado y de Kruskal Wallis con el programa SPSS V.20.0, considerando significativa p0.05.Se estudiaron 96 pacientes de 32.6 ± 6.1 años. Tuvieron acretismo el 38.5%, incretismo el 19.8% y percretismo el 18.8%. Se hizo histerectomía total a 78 (81.2%). Presentaron lesión urinaria 27 (28.1%): vesical 19, ureteral 6 y ambas 2. La lesión urinaria fue más frecuente en las pacientes que tuvieron más gestas (4 [rango intercuartílico (RIQ): 3-4] vs. 3 [2-4]; p = 0.004), más cesáreas (4 [3-4] vs. 2 [1-3]; p0.001), mayor sangrado (3000 ml [2000-4800] vs. 2000 ml [1200-3000]; p = 0.001) y mayor tiempo quirúrgico (3.75 h [3.5-4.0] vs. 3.0 [2.0-3.5]; p0.001).La lesión urinaria fue más frecuente en las pacientes que tuvieron mayor número de gestas, más cesáreas, más sangrado y mayor tiempo quirúrgico. |
| Databáze: | OpenAIRE |
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