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Year :2018
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Month :
January-February
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Volume :
7
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Issue :
1
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Page :
OO01 - OO05
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Emergency Peripartum Hysterectomy in the Eastern Region of Turkey: Incidence and Maternal Morbidity
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Correspondence Address :
Ersin Çintesun, Feyza Nur Incesu Çintesun,
1. Faculty, Department of Obstetrics and Gynaecology,
Selcuk University, Konya, Turkey.
2. Faculty, Department of Obstetrics and Gynaecology,
Konya Education and Research Hospital, Konya,
Turkey.
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Introduction: Introduction: Emergency Peripartum Hysterectomy (EPH) is a life saving procedure that is used to control massive haemorrhages that occur 24 hours after vaginal or cesarean delivery. It is a major operation and is invariably performed in the presence of life threatening haemorrhage during or immediately after abdominal or vaginal deliveries.
Aim: To investigate and report the incidence, risk factors, outcomes and complications associated with EPH procedures that were performed within a 3.5 years period, at a state hospital in the eastern region of Turkey.
Materials and Methods: A retrospective study of deliveries that were recorded between January 2012 and April 2016 at the Agri State Hospital in Turkey. Data such as the age of patient, gestational age, gravidity, parity, previous abortion status, haemoglobin deficiency, first minute APGAR score, postoperative hospitalization days, need for blood units and fresh frozen plasma units, previous history of Cesarean Section (CS), mode of delivery, cesarean indications for current delivery, indication, type and risk factors associated with EPH, perioperative complications, and fetal outcome were retrieved from the hospital computer database.
Results: In a total of 25,609 deliveries 37 peripartum hysterectomies (rate of 1.4/1000 deliveries) were performed while nine were performed after vaginal deliveries and 28 were performed after CS. Uterine atony, 13 (35.1%) was the most common indication for EPH. In all 12 (32%) in subtotal and 25 (68%) in total hysterectomies were performed. Twenty eight patients had blood transfusions of over two units. Two (5.4%) patients had to be re-explored due to the internal bleeding while 7(18.9%) had no further complications. No maternal deaths were reported.
Conclusion: EPH should be performed with a multidisciplinary team approach immediately. The patients at risk for uterine atony and placenta acreata should be determined before labor and necessary precautions should be taken.
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