对13年间59例围产期紧急子宫切除术的分析。

Analysis of 59 cases of emergent peripartum hysterectomies during a 13-year period.

作者信息

Ozden Selçuk, Yildirim G, Basaran T, Gurbuz B, Dayicioglu V

机构信息

Zeynep Kamil Women and Children Education and Research Hospital, Istanbul, Turkey.

出版信息

Arch Gynecol Obstet. 2005 Apr;271(4):363-7. doi: 10.1007/s00404-004-0647-5. Epub 2004 Jun 15.

DOI:10.1007/s00404-004-0647-5

PMID:15205986

Abstract

OBJECTIVE

The objective was to investigate the incidence, indications, and risk factors of peripartum emergent hysterectomy.

METHOD

Fifty-nine cases of emergent peripartum hysterectomy performed at Zeynep Kamil Women and Children's Education and Research Hospital during a 13-year period between January 1990 and January 2003 were evaluated retrospectively. Emergent peripartum hysterectomy was defined as that performed for haemorrhage unresponsive to other therapeutic interventions within the first 24 h of delivery.

RESULT

Emergent peripartum hysterectomy was performed in 59 cases of 234,958 women (25.1/100,000). Total and subtotal hysterectomy was performed in 25 and 34 cases respectively. The rates of emergent peripartum hysterectomy after vaginal and caesarean deliveries were 8.7/100,000 and 104.5/100,000 respectively. Uterine atony was the most frequent indication (62.7%). The rates of emergent peripartum hysterectomy due to uterine atony in primiparous and multiparous women were 61.1 and 65.2% respectively. The rate of maternal mortality was 8% (5 cases).

CONCLUSION

Uterine atony was the most common indication for emergent peripartum hysterectomy.

摘要

目的

本研究旨在调查围产期急诊子宫切除术的发生率、适应症及危险因素。

方法

回顾性分析1990年1月至2003年1月期间在泽伊内普·卡米尔妇女儿童教育与研究医院进行的13年间59例围产期急诊子宫切除术。围产期急诊子宫切除术定义为在分娩后24小时内对其他治疗干预无反应的出血情况下进行的手术。

结果

在234958名妇女中有59例行围产期急诊子宫切除术（25.1/10万）。其中25例行全子宫切除术，34例行次全子宫切除术。阴道分娩和剖宫产术后围产期急诊子宫切除术的发生率分别为8.7/10万和104.5/10万。宫缩乏力是最常见的适应症（62.7%）。初产妇和经产妇因宫缩乏力行围产期急诊子宫切除术的发生率分别为61.1%和65.2%。孕产妇死亡率为8%（5例）。