Radnia Nahid, Manouchehrian Nahid, Shayan Arezoo, Shirmohamadi Nasrin, Eskandarloo Tahereh, Otogara Marziyeh
Assistant Professor, Clinical Research Development Unit of Fatemieh Hospital, Department of Genecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
MD., Associate Professor, Department of Anesthesiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
Electron Physician. 2017 Jun 25;9(6):4643-4647. doi: 10.19082/4643. eCollection 2017 Jun.
Emergency hysterectomy (peripartum) is a high-risk surgery that almost always is done in the treatment or prevention of severe and life-threatening bleeding that occurs after vaginal delivery or caesarean.
To compare the frequency and causes of emergency hysterectomy along with the vaginal delivery and caesarean section (CS).
The cross-sectional research was conducted on patients who underwent a peripartum hysterectomy from 2005 to 2015 at Fatemieh Hospital in Hamadan City, Iran. Data collection tools included a questionnaire about demographic features and factors associated with hysterectomy surgery. Data were analyzed using SPSS version 21 and by descriptive statistics, chi-square, paired t-test, and one-way analysis of variance (ANOVA).
The mean age of women was 33.4±5.09 years. In recent years, 37 cases of hysterectomy were reported, with the peak occurring in 2015. The highest prevalence of hysterectomy was associated with 28 (77.8%) women with a third pregnancy and second parity, while 32 cases (86.5) were related to those with no history of vaginal delivery, 15 (45.5%) were related to repeated CS and second repeated CS; 28 cases (75.7%) to those with no history of placenta previa; 21 cases (56.8) to the majority with the anterior placenta;, 33 cases (97.1%) to those with no over-distance of uterine; and 36 cases (97.3%) to those without a history of uterine myoma. Among 37 cases who had hysterectomy, placenta accreta was observed in 27 cases (77.1%), with placenta increta in three (8.1%) and placental attachment, including percreta, were seen in seven cases (18.9 %).
The rate of hysterectomy in multiparous women (in their third or fourth pregnancy) was higher. The greatest cause of hysterectomy was related to attached placenta including accreta, uterus atony, a history of CS, multipara, and repeated CS. Therefore, due to the increase in the number of CSs in recent years, planning should be taken into account in order to encourage pregnant women for vaginal delivery.
急诊子宫切除术（围产期）是一项高风险手术，几乎总是用于治疗或预防阴道分娩或剖宫产术后发生的严重且危及生命的出血。
比较急诊子宫切除术的频率和原因以及阴道分娩和剖宫产情况。
对2005年至2015年在伊朗哈马丹市法特米耶医院接受围产期子宫切除术的患者进行横断面研究。数据收集工具包括一份关于人口统计学特征和与子宫切除手术相关因素的问卷。使用SPSS 21版软件进行数据分析，并采用描述性统计、卡方检验、配对t检验和单因素方差分析（ANOVA）。
女性的平均年龄为33.4±5.09岁。近年来，共报告了37例子宫切除术病例，高峰出现在2015年。子宫切除术的最高患病率与28例（77.8%）第三次妊娠且经产一次的女性相关，而32例（86.5%）与无阴道分娩史的女性相关，15例（45.5%）与重复剖宫产和第二次重复剖宫产相关；28例（75.7%）与无前置胎盘史的女性相关；21例（56.8%）与多数胎盘位于前位的女性相关；33例（97.1%）与子宫无过度伸展的女性相关；36例（97.3%）与无子宫肌瘤病史的女性相关。在37例行子宫切除术的病例中，27例（77.1%）观察到胎盘植入，3例（8.1%）为胎盘侵入，7例（18.9%）可见胎盘附着包括穿透性胎盘植入。
经产妇（第三次或第四次妊娠）的子宫切除率较高。子宫切除的最主要原因与胎盘附着有关，包括植入、子宫收缩乏力、剖宫产史、经产妇和重复剖宫产。因此，鉴于近年来剖宫产数量的增加，应考虑采取措施鼓励孕妇进行阴道分娩。
