紧急围产期子宫切除术的适应证与结局：一项五年回顾

Indications for and outcomes of emergency peripartum hysterectomy. A five-year review.

作者信息

Bakshi S, Meyer B A

机构信息

Department of Obstetrics and Gynecology, University Medical Center, State University of New York at Stony Brook 11794-8091, USA.

出版信息

J Reprod Med. 2000 Sep;45(9):733-7.

PMID:11027082

Abstract

OBJECTIVE

To review risk factors, management and outcomes of emergency peripartum hysterectomy performed in the last five years at Stony Brook University Hospital.

STUDY DESIGN

Retrospective descriptive and cohort analyses from January 1990 to January 1995. Incidences of emergency peripartum hysterectomy and placenta accreta were determined. Relative risks of hysterectomy for specified risk factors were calculated.

RESULTS

There were 39 cases of emergency peripartum hysterectomy, for an overall incidence of 2.7/1,000 births. Indications for emergency hysterectomy were placenta accreta, unspecified bleeding, uterine rupture, myomas and atony with placenta accreta, the most common. The crude relative risk of emergency hysterectomy was 46.9 (n = 37) for cesarean delivery, 15.24 (n = 31) for prior cesarean delivery and 110.83 (n = 21) for placenta previa.

CONCLUSION

Cesarean delivery, prior cesarean delivery, placenta accreta and uterine atony were identified as risk factors for emergency peripartum hysterectomy, and abnormal placentation was the primary cause of cesarean hysterectomy.

摘要

目的

回顾过去五年在石溪大学医院进行的急诊剖宫产子宫切除术的危险因素、管理及结果。

研究设计

对1990年1月至1995年1月进行回顾性描述性和队列分析。确定急诊剖宫产子宫切除术和胎盘植入的发生率。计算特定危险因素子宫切除的相对风险。

结果

有39例急诊剖宫产子宫切除术，总发生率为2.7/1000例分娩。急诊子宫切除的指征为胎盘植入、不明原因出血、子宫破裂、肌瘤和伴有胎盘植入的宫缩乏力，其中最常见的是胎盘植入。剖宫产的急诊子宫切除粗相对风险为46.9（n = 37），既往剖宫产为15.24（n = 31），前置胎盘为110.83（n = 21）。