Güngördük K, Yildirim G, Dugan N, Polat I, Sudolmus S, Ark C
Department of Obstetrics and Gynecology, Istanbul Bakirkoy Women's and Children's Hospital, Istanbul, Turkey.
J Obstet Gynaecol. 2009 Nov;29(8):722-8. doi: 10.3109/01443610903168358.
This was a retrospective review of all cases of peripartum obstetric hysterectomy performed at the Istanbul Bakirkoy Women and Children's Teaching Hospital in the period between January 2001 and September 2008. We included any women who required emergency hysterectomy to control major postpartum haemorrhage after delivery. During the study period, there were 91 cases of peripartum hysterectomy. Two controls per case were randomly selected from the remaining births by using the random table. The incidence of emergency peripartum hysterectomy was 0.67 in 1,000 deliveries. The main indication for emergency hysterectomy was uterine atony in 52 cases (57.1%). The most independent risk factors for emergency hysterectomy were multiparity (odds ratios (OR) 17.3, 95% confidence interval (95% CI) 8.7-34.6); caesarean delivery in index delivery (OR 6.7, 95% CI 3.8-11.9) and caesarean section for placental abruption (OR 3.8, 95% CI 0.4-33.4). Our study suggests that multiparity, primary or repeat caesarean deliveries for placental abruption are independently associated risks for peripartum hysterectomy and uterine atony is the still most common indication for peripartum hysterectomy in Turkey.
这是一项对2001年1月至2008年9月期间在伊斯坦布尔巴克尔柯伊妇女儿童医院进行的所有围产期产科子宫切除术病例的回顾性研究。我们纳入了所有分娩后因控制严重产后出血而需要紧急子宫切除术的妇女。在研究期间，共有91例围产期子宫切除术病例。通过随机数字表从其余分娩中为每个病例随机选取两名对照。围产期紧急子宫切除术的发生率为每1000例分娩中有0.67例。紧急子宫切除术的主要指征是宫缩乏力，共52例（57.1%）。紧急子宫切除术最独立的危险因素是多胎妊娠（比值比（OR）17.3，95%置信区间（95%CI）8.7 - 34.6）；本次分娩为剖宫产（OR 6.7，95%CI 3.8 - 11.9）以及因胎盘早剥行剖宫产（OR 3.8，95%CI 0.4 - 33.4）。我们的研究表明，多胎妊娠、因胎盘早剥行初次或再次剖宫产是围产期子宫切除术独立的相关风险因素，并且宫缩乏力仍是土耳其围产期子宫切除术最常见的指征。
