Baskett T F
Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.
J Obstet Gynaecol. 2003 Jul;23(4):353-5. doi: 10.1080/0144361031000119466.
A population-based review (1988-2000) of 142,634 deliveries found an incidence of emergency obstetric hysterectomy of 0.53 per 1000 deliveries. The relative risk for caesarean versus vaginal delivery was 18.32 (10.26, 32.71) P<0.001. Previous caesarean delivery occurred in 47.4% and 22.4% were primiparous. Causes and morbidity were ascertained in a hospital-based study (1980-2001) of 64 emergency hysterectomies in 110,537 deliveries. The main indications for hysterectomy were abnormal placentation (50%) and atonic postpartum haemorrhage (32.8%). Blood transfusion was needed in 84.4% and intensive care in 26.6%. There were no maternal deaths. Potential alternatives to hysterectomy for massive obstetric haemorrhage are discussed.
一项基于人群的回顾性研究（1988 - 2000年）对142,634例分娩进行了分析，结果发现急诊产科子宫切除术的发生率为每1000例分娩中有0.53例。剖宫产与阴道分娩的相对风险为18.32（10.26，32.71），P<0.001。既往有剖宫产史的产妇占47.4%，初产妇占22.4%。在一项基于医院的研究（1980 - 2001年）中，对110,537例分娩中的64例急诊子宫切除术的病因和发病率进行了确定。子宫切除术的主要指征是胎盘异常（50%）和产后宫缩乏力性出血（32.8%）。84.4%的患者需要输血，26.6%的患者需要重症监护。无孕产妇死亡。文中讨论了针对大量产科出血进行子宫切除术的潜在替代方案。
