未生育女性患者的急诊围产期子宫切除术

Emergency peripartum hysterectomy in the nulliparous patient.

作者信息

Seffah J D, Kwame-Aryee R A

机构信息

Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana.

出版信息

Int J Gynaecol Obstet. 2007 Apr;97(1):45-6. doi: 10.1016/j.ijgo.2006.11.018. Epub 2007 Feb 21.

DOI:10.1016/j.ijgo.2006.11.018

PMID:17316643

Abstract

OBJECTIVE

To find out the incidence, indications and outcomes of emergency peripartum hysterectomy in the nulliparous woman.

METHOD

Retrospective study at the Korle Bu Teaching Hospital in Accra, Ghana, between January 1995 and December 2003.

RESULTS

During the eight-year study period there were 92,966 deliveries out of which 36,550 (39.5%) were for the nulliparous. Peripartum hysterectomy was performed for 39 nulliparous women, thus giving an incidence of 1 per 1000 nulliparous deliveries. The indications for the hysterectomy were: atonic uterus 28 (71.8%), ruptured uterus 8 (20.5%) and placenta praevia/accreta 3 (7.7%). The perinatal losses were 8 (20.5%) and the total blood loss ranged from 1 to 4.5 l. There were no maternal deaths but there were 7 near-missed fatalities.

CONCLUSION

Though rare, peripartum hysterectomy in the nulliparous patients carries high maternal morbidity and perinatal mortality.

摘要

目的

了解未产妇紧急剖宫产子宫切除术的发生率、适应证及结局。

方法

对1995年1月至2003年12月期间加纳阿克拉的科勒布教学医院进行回顾性研究。

结果

在为期八年的研究期间，共分娩92966例，其中36550例（39.5%）为未产妇。对39例未产妇实施了剖宫产子宫切除术，发生率为每1000例未产妇分娩中有1例。子宫切除术的适应证为：宫缩乏力28例（71.8%）、子宫破裂8例（20.5%）、前置胎盘/植入性胎盘3例（7.7%）。围产期死亡8例（20.5%），总失血量为1至4.5升。无孕产妇死亡，但有7例险些致命。