ORIGINAL PAPER
HYSTERECTOMY IN THE PERINATAL AND POSTPARTUM PERIOD IN THE 17-YEAR CLINICAL MATERIAL
Publication date: 2013-11-26
Medical Studies 2013;29(1):39-50
KEYWORDS
ABSTRACT
Intruduction: Hysterectomy is one of major surgeries. Pregnancy, delivery and postpartum period make the operation even more difficult as it is forced and complicated by various pathological conditions that develop over that time.
Objective: The purpose of study was to analyze the frequency of hysterectomy, indications to undertake it and complications associated with the removal of the uterus in pregnancy and during perinatal and postpartum period. The study analyzed the cases of hysterectomies in perinatal and postpartum period performed over the 17-year clinical material from the Department of Gynaecology and Obstetrics, SZOZ, Lipsko in the years 1985–2001.
Material and methods: The material for analysis were medical records of 15 women who developed complications in pregnancy, perinatal and postpartum period, which were absolute indication to perform hysterectomy. The following parameters were analyzed: patient’s age, number of deliveries, the way pregnancies were terminated, the way present pregnancy was terminated, complications, indications to Caesarean section and perinatal and postpartum hysterectomy, type of hysterectomy performed, other associated procedures and complications.
Results: In total 15 hysterectomies were performed in the period of study which accounts for 0.10% all deliveries. The material revealed the following causes for hysterectomy: placental pathologies (46.7%), inflammatory conditions of internal sex organs (20.0%), uterine atonia after delivery (13.3%), injuries of sex organs (13.3%). Elective hysterectomy in that period was performed in one patient (6.7%). The risk factors predisposing to complications resulting in hysterectomy were history of Caesarean sections in 10 patients (66.7%) and multiple spontaneous deliveries. Complications associated with hysterectomy which enforced additional operations were noted in two cases (13.3%). Total hysterectomy was performed in 8 patients (53.3%) including hysterectomy with adnexia in 3 women (20.0%). Amputation of the uterine body without adnexia was performed in 7 women (46.7%). No complications were noted after hysterectomies performed in the perinatal and postpartum period.
Conclusions: Most common causes of hysterectomies during perinatal and postpartum period were placental pathology associated with massive loss of blood and uterine atonia after delivery. Amputation of the uterine body was enough without other associated procedures in 46.7% cases. Patients with the history of Caesarean sections and multiple deliveries made 66.7% of hysterectomies performed in the perinatal and postpartum period.
Objective: The purpose of study was to analyze the frequency of hysterectomy, indications to undertake it and complications associated with the removal of the uterus in pregnancy and during perinatal and postpartum period. The study analyzed the cases of hysterectomies in perinatal and postpartum period performed over the 17-year clinical material from the Department of Gynaecology and Obstetrics, SZOZ, Lipsko in the years 1985–2001.
Material and methods: The material for analysis were medical records of 15 women who developed complications in pregnancy, perinatal and postpartum period, which were absolute indication to perform hysterectomy. The following parameters were analyzed: patient’s age, number of deliveries, the way pregnancies were terminated, the way present pregnancy was terminated, complications, indications to Caesarean section and perinatal and postpartum hysterectomy, type of hysterectomy performed, other associated procedures and complications.
Results: In total 15 hysterectomies were performed in the period of study which accounts for 0.10% all deliveries. The material revealed the following causes for hysterectomy: placental pathologies (46.7%), inflammatory conditions of internal sex organs (20.0%), uterine atonia after delivery (13.3%), injuries of sex organs (13.3%). Elective hysterectomy in that period was performed in one patient (6.7%). The risk factors predisposing to complications resulting in hysterectomy were history of Caesarean sections in 10 patients (66.7%) and multiple spontaneous deliveries. Complications associated with hysterectomy which enforced additional operations were noted in two cases (13.3%). Total hysterectomy was performed in 8 patients (53.3%) including hysterectomy with adnexia in 3 women (20.0%). Amputation of the uterine body without adnexia was performed in 7 women (46.7%). No complications were noted after hysterectomies performed in the perinatal and postpartum period.
Conclusions: Most common causes of hysterectomies during perinatal and postpartum period were placental pathology associated with massive loss of blood and uterine atonia after delivery. Amputation of the uterine body was enough without other associated procedures in 46.7% cases. Patients with the history of Caesarean sections and multiple deliveries made 66.7% of hysterectomies performed in the perinatal and postpartum period.
REFERENCES (24)
1.
Glaze S, Ekwalanga P, Roberts G et al. Peripartum hysterectomy: 1999 to 2006. Obstet Gynecol 2008; 111: 732–738.
2.
Yamamoto H, Sagae S, Nishikawa S et al. Emergency postpartum hysterectomy in obstetric practice. J Obstet Gynecol Res 2000; 26: 341–345.
3.
Taylor AA, Sanusi FA, Riddle AF. Expectant management of placenta accreta following stillbirth at term: a case report. Eur J Obstet Gynecol Reprod Biol 2001; 96(2): 220–222.
4.
Poręba R, Jastrzębski A, Obcowska-Lech M i wsp. Okołoporodowe wycięcie macicy w nagłych przypadkach położniczych. Klin Perinat Gin 2007; 43(4): 29–31.
5.
Sikora-Szczęśniak DL, Sikora W. Oszczędzające leczenie operacyjne nowotworów złośliwych jajnika u kobiet w wieku rozrodczym. Ginekol Pol 2012; 83(1): 27–32.
6.
Sikora-Szczęśniak DL. Powierzchowne pęknięcie macicy po porodzie miednicowym – opis przypadku. Ginekol Pol 2012; 83(5): 380–383.
7.
Rabenda-Łącka K, Wilczyński J, Radoch Z i wsp. Okołoporodowe wycięcie macicy. Ginekol Pol 2003; 74: 1521–1525.
8.
Reroń A, Trojnar-Podleśny K, JaworowskiAi wsp. Okołoporodowe wycięcie macicy. Prz Ginekol Położ 2003; 3: 207–212.
9.
Bachanek M, Sawicki W, Cendrowski K i wsp. Okołoporodowe wycięcie macicy. W: Reoperacje w ginekologii. Red. JA Jakowicki. BiFolium, Lublin 2004: 185.
10.
Awan N, Bennett MJ, Walters WA. Emergency peripartum hysterectomy: a 10-year review at the Royal Hospital for Women, Sydney. Aust NZJ Obstet Gynaecol 2011; 51(3): 210–215.
11.
Szpejankowski K, Obrzut B, Kluz T i wsp. Retrospektywna analiza operacji okołoporodowego wycię- cia macicy. Ginekol Prakt 2007; 15(1): 11–14.
12.
Rahman J, Al.-Ali M, Qutub H et al. Emergency obstetric hysterectomy in a university hospital: A 25- -year review. J Obstet Gynaecol 2008; 28: 69–72.
13.
Knight M, Kurinczuk JJ, Spark P et al. Cesarean delivery and peripartum hysterectomy. Obstet Gynecol 2008; 111: 97–105.
14.
Engelsen I, Albrechtsen S, Iversen O. Peripartum hysterectomy-incidence and maternal morbidity. Acta Obstet Gynecol Scand 2001; 80: 409–412.
15.
Yamani Zamzami TY. Indication of emergency peripartum hysterectomy: review of 17 cases. Arch Gynecol Obstet 2003; 268: 131–135.
16.
Tapisiz OL, Altinbas SK, Yirci B et al. Emergency peripartum hysterectomy in a tertiary hospital in Ankara, Turkey: a 5-year review. Arch Gynecol Obstet 2012; 286(5): 1131–1134.
Christopoulos P, Hassiakos D, Tsitoura A et al. Obstetric hysterectomy: a review of cases over 16 years. J Obstet Gynaecol 2011; 31(2): 139–141.
17.
Chanrachakul B, Chaturachinda K, Phuspradit W et al. Cesarean and post partum hysterectomy. Int J Gynecol Obstet 1996; 54(2): 109–113.
18.
Kwee A, Bots M, Visser G et al. Emergency peripartum hysterectomy: a prospective study in The Netherlands. Eur J Obstet Gynecol Reprod Biol 2006; 124: 187–192.
19.
Kwame-Aryee R, Kwakye A, Seffah J. Peripartum hysterectomies at the korle-bu teaching hospital: a review of 182 consecutive cases. Ghana Al J 2007; 41: 133–138.
20.
Smith J, Mousa H. Peripartum hysterectomy for primary postpartum haemorrhage: incidence and maternal morbidity. J Obstet Gynecol 2007; 27: 44–47.
21.
Fatima M, Kasi PM, Baloch SN et al. Experience of emergency peripartum hysterectomies at a tertiary care Hospital in Quetta, Pakistan. ISRN Obstet Gynecol 2011; 854202.
22.
Machado LSM. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome. N Am J Med Sci 2011; 3(8): 358–361.
23.
Yucel O, Ozdemir I, Yucel N et al. Emergency peripartum hysterectomy: a 9-year review. Arch Gynecol Obstet 2006; 274: 84–87.
24.
Forna F, Miles A, Jamieson D. Emergency peripartum hysterectomy: a comparison of cesarean and postpartum hysterectomy. Am J Obstet Gynecol 2004; 190: 1440–1444.
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
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