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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 02

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Ginecol Obstet Mex 2021; 89 (02)

Experience in obstetric hysterectomy and vascular control in Northeastern Mexico

López-Vera EA, Reynosa-Oviedo Y, Martínez-Salazar GJ, Bazaldúa-Cruz JJ, Álvarez-Chávez LD, Balderas-Cerda IA

Language: Spanish
References: 16
Page: 109-114
PDF size: 195.43 Kb.


ABSTRACT

Objective: To determine the incidence of obstetric hysterectomy (indications, outcomes and immediate complications and mediates associated with maternal morbidity and mortality) and to describe the accumulated experience with the immediate response team in northeastern Mexico.
Materials and Methods: Observational, descriptive and retrospective cohort study conducted between January 1, 2012 and December 31, 2015 at the High Specialty Medical Unit 23 located in Monterrey, NL, based on the review of clinical records of patients with obstetric bleeding and hysterectomy. Non-probabilistic sampling, of consecutive cases. The incidence of obstetric hysterectomy and percentages of vascular control were calculated. Descriptive statistics were used for variables: age, number of pregnancies, weeks of pregnancy, amount of bleeding, transfused blood products, trans-surgical time and associated complications.
Results: 84,579 obstetric procedures were performed and the cumulative incidence of hysterectomy was 4.5 per 1000 patients. Average age 31.9 5.48 years. In more than 88% of hysterectomies, vascular control was performed by selective arterial ligation prior to the procedure. Abnormal placentation was the most frequent indication (59.5%), all patients required a transfusion. There were two maternal deaths not directly associated with the obstetric procedure.
Conclusions: The cumulative incidence of obstetric hysterectomy and the vascular control applied reflect the good attention and the absence of maternal deaths secondary to the procedure or to the surgical technique. The obstetric hysterectomy with vascular control and the permanent training of the medical personnel who care for the patients with bleeding avoided the fatal outcomes.


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