Daskalakis George, Anastasakis Eleftherios, Papantoniou Nikolaos, Mesogitis Spyros, Theodora Mariana, Antsaklis Aris
1st Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, 80 Vas. Sofias Av., Athens, Greece.
Acta Obstet Gynecol Scand. 2007;86(2):223-7. doi: 10.1080/00016340601088448.
All cases of obstetric hysterectomies that were performed in our hospital during a seven-year study period were reviewed in order to evaluate the incidence, indications, risk factors, and complications associated with emergency obstetric hysterectomy.
Medical records of 45 patients who had undergone emergency hysterectomy were scrutinized and evaluated retrospectively. Maternal age, parity, gestational age, indication for hysterectomy, the type of operation performed, estimated blood loss, amount of blood transfused, complications, and hospitalization period were noted and evaluated. The main outcome measures were the factors associated with obstetric hysterectomy as well as the indications for the procedure.
During the study period there were 32,338 deliveries and 9,601 of them (29.7%) were by cesarean section. In this period, 45 emergency hysterectomies were performed, with an incidence of 1 in 2,526 vaginal deliveries and 1 in 267 cesarean sections. All of them were due to massive postpartum hemorrhage. The most common underlying pathologies was placenta accreta (51.1%) and placenta previa (26.7%). There was no maternal mortality.
Obstetric hysterectomy is a necessary life-saving procedure. Abnormal placentation is the leading cause of emergency hysterectomy when obstetric practice is characterized by a high cesarean section rate. Therefore, every attempt should be made to reduce the cesarean section rate by performing this procedure only for valid clinical indications.
回顾我院在七年研究期间实施的所有产科子宫切除术病例，以评估与急诊产科子宫切除术相关的发生率、适应症、危险因素和并发症。
对45例行急诊子宫切除术患者的病历进行回顾性审查和评估。记录并评估产妇年龄、产次、孕周、子宫切除适应症、手术类型、估计失血量、输血量、并发症及住院时间。主要观察指标为与产科子宫切除术相关的因素以及该手术的适应症。
研究期间共分娩32338例，其中9601例（29.7%）为剖宫产。在此期间，共实施45例急诊子宫切除术，阴道分娩发生率为1/2526，剖宫产发生率为1/267。所有手术均因产后大出血。最常见的潜在病理情况是胎盘植入（51.1%）和前置胎盘（26.7%）。无孕产妇死亡。
产科子宫切除术是一项必要的挽救生命的手术。当产科实践中剖宫产率较高时，胎盘异常是急诊子宫切除术的主要原因。因此，应仅在有有效临床指征时进行该手术，以尽一切努力降低剖宫产率。
