产褥期子宫切除术有哪些新进展？一家三级医院的 17 年经验。

What is new in peripartum hysterectomy? A seventeen year experience in a tertiary hospital.

机构信息

Istanbul Health Sciences University Kanuni Sultan Suleyman Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Medipol University Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey.

出版信息

Taiwan J Obstet Gynecol. 2021 Jan;60(1):95-98. doi: 10.1016/j.tjog.2020.11.014.

DOI:10.1016/j.tjog.2020.11.014

PMID:33495017

Abstract

OBJECTIVE

To identify changing trends in peripartum hysterectomy (PH), both elective. cesarean hysterectomy and emergency cesarean hysterectomy, at a single training and research hospital over the last 17 years in Istanbul, Turkey.

MATERIALS AND METHODS

A retrospective cohort study was performed between January 2001 and September 2017. The records of all patients who had PH at Kanuni Sultan Süleyman Training and Research Hospital were analyzed.

RESULTS

There were 243 cases of PH during the study period. A total of 266,386 births occurred, of which 60.1% were vaginal deliveries and 39.8% were cesarean sections. The incidence of PH increased from 0.67 per 1000 deliveries to 1.14 per 1000 deliveries during 2001-2008 and 2009-2017, respectively, with an overall incidence of 0.91 per 1000 deliveries during the 17 years. The main indication for PH changed significantly during this time from uterine atony (57.1%) to placenta accreta spectrum (85%). About 37% of women who underwent PH had at least one previous cesarean delivery during 2001-2008, whereas that percentage increased to 95.4% during 2009-2017.

CONCLUSION

Placenta accreta spectrum was the leading cause of PH and was associated with significant maternal morbidity and mortality.

摘要

目的

在土耳其伊斯坦布尔的一家培训和研究医院，回顾性分析过去 17 年来，因各种原因行剖宫产术时的子宫切除术（PH），包括择期剖宫产术时子宫切除术和紧急剖宫产术时子宫切除术的变化趋势。

材料和方法

该研究为回顾性队列研究，时间为 2001 年 1 月至 2017 年 9 月。对 Kanuni Sultan Süleyman 培训和研究医院所有行 PH 的患者记录进行分析。

结果

在研究期间，共有 243 例 PH 患者。共发生 266386 例分娩，其中 60.1%为阴道分娩，39.8%为剖宫产。PH 的发病率从 2001-2008 年的 0.67/1000 次分娩增加到 2009-2017 年的 1.14/1000 次分娩，17 年间的总发病率为 0.91/1000 次分娩。在此期间，PH 的主要指征从宫缩乏力（57.1%）显著转变为胎盘植入谱系疾病（85%）。在 2001-2008 年期间，37%的行 PH 的女性至少有一次剖宫产史，而在 2009-2017 年期间，这一比例增加到 95.4%。