Reveles VJA, Villegas RG, Hernández HS, Grover PF, Hernández VCC, Patiño SA

Language: Spanish
References: 11
Page: 156-160
PDF size: 157.02 Kb.

ABSTRACT

Background: Obstetric hysterectomy is indicated when patient’s life is at risk, and it is a procedure that requires a highly experienced and skilled medical team to solve any complication.
Objective: To identify incidence, indications, and complications of obstetric hysterectomy within a high-risk population.
Patients and methods: Transversal, retrospective study from July 1^st 2004 to June 30 2006 at Unidad Medica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Medico Nacional de Occidente, IMSS. There were reviewed 103 patient’ files with obstetric hysterectomy. Incidence was calculated, and clinical and socio-demographic characteristics, indications, and complications of obstetric hysterectomy identified and expressed in frequency, percentages, and central tendency measurements.
Results: Incidence of obstetric hysterectomy was 8 cases within every 1,000 obstetric consultation. Age average was 31.1 ± 5.1 years. 72.8% had cesarean surgery history. Main indication was placenta previa associated with placenta accreta (33%), followed by uterine hypotony (22.3%). Complications were hypovolemic shock (56.3%), and vesical injuries (5.8%). There were no maternal deaths.
Conclusions: Cesarean history induces higher obstetric hysterectomy incidence in women with high-risk pregnancy, due to its relation to placentation disorders, as placenta previa that increases hemorrhage possibility, and thus, maternal morbidity and mortality.

REFERENCES

1. Whiteman MK, Kurlina E, Hillis SD, Jamiesom DJ. Incidence and determinants of peripartum hysterectomy. ACOG 2006;108(6):1486-92.

2. Engelsen I, Albechtsen S, Iversen O. Peripartum hysterectomy. Incidence and maternal morbidity. Acta Obstet Gynecol Scand 2001;80:409-12.

3. Briery CM, Rose CH, Hudson WT, Lutgendorf MA et al. Planned vs emergent cesarean hysterectomy. Am J Obstet Gynecol 2007;154:e1-e5.

4. Knight M, Kurinczuk JJ, Spark P, Brocklehurst P. Cesarean delivery and peripartum hysterectomy. Obstet Gynecol 2008;111(1):97-105.

5. Kacmar J, Bhimani L, Boyd M, Shah-Hosseini R, Peipert JF. Route of delivery as a risk factor for emergent peripartum hysterectomy: A case-control study. ACOG 2003;102(1):141-5.

6. Roopnarinesingh R, Fay L, McKenna P. A 27-year review of obstetric hysterectomy. J Obstet Gynecol 2003;23(3):252-4.

7. Baskett TF. Emergency obstetric hysterectomy. J Obstet Gynecol 2003;23(4):353-5.

8. Forna F, Miles AM, Jamieson DJ. Emergency peripartum hysterectomy: A comparison of cesarean and postpartum hysterectomy. Am J Obstet Gynecol 2004;190:1440-4.

9. Nava FJ, Páez AJ, Veloz MG, Sánchez VV, Hernández VM. Indicaciones y factores de riesgo para histerectomía obstétrica de urgencia. Ginecol Obstet Mex 2002;70:289-94.

10. Quesnel GBC, Ahued JR, Rivera J, Obeid LJ. Obstetric hysterectomy. A review of 675 cases at the Instituto Nacional de Perinatologia. Ginecol Obstet Mex 1997;65(3):119-24.

11. Hofmeyr JG, Lale B, Gulmezoglu MAB. WHO systematic review of maternal mortality and morbidity: The prevalence of uterine rupture [Review]. BJOG 2005;112(9):1221-8.