十五年期间的产后子宫切除术。
Peripartum Hysterectomies over a Fifteen-year Period.
机构信息
Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
出版信息
Rev Bras Ginecol Obstet. 2021 Jan;43(1):3-8. doi: 10.1055/s-0040-1721354. Epub 2021 Jan 29.
OBJECTIVE
To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure.
METHODS
A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019.
RESULTS
The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age.
CONCLUSION
Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.
目的
确定过去 15 年在巴西南部的一所大学附属医院——阿雷格里港临床医院（Hospital de Clínicas de Porto Alegre）进行的围产期子宫切除术的适应证和结果，并分析接受该手术的妇女的临床特征。
方法
这是一项回顾性研究，共纳入了 2005 年至 2019 年期间进行的 47 例围产期子宫切除术。
结果
我院进行的围产期子宫切除术主要是由于胎盘植入或疑似胎盘植入（占 44.7%）、无胎盘植入的产后出血（占 27.7%）和感染（占 25.5%）。全子宫切除术占 63.8%，我们发现研究结果中全子宫切除术与次全子宫切除术之间没有差异。大多数子宫切除术是在分娩后 24 小时内进行的，并且与胎盘植入、前置胎盘和产妇年龄较大有关。
结论
大多数（66.0%）患者被收入重症监护病房（ICU）。那些不需要入住 ICU 的患者明显年龄更大，且更可能患有胎盘植入、前置胎盘或既往剖宫产。
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