Department of Gynecology and Obstetrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Ethiop J Health Sci. 2022 Mar;32(2):289-296. doi: 10.4314/ejhs.v32i2.9.
Peripartum hysterectomy (PPH) is one of the effective treatment modalities which is increasingly performed to save the life of pregnant women with uncontrollable severe postpartum hemorrhage. The aim of this study was to assess the prevalence and factors associated with PPH among Iranian pregnant women.
In a retrospective study, 33 pregnant women with PPH referred to Imam Khomeini Hospital in Sari, Mazandaran province, northern Iran were enrolled. Data were collected using census sampling from March 2017 to 2020. Patients' sociodemographic and clinical characteristics were collected. Fisher's exact test, Kruskal-Wallis, and Mann-Whitney tests were used to evaluate the study variables.
The prevalence of PPH among Iranian pregnant women was 2.81 per 1000 deliveries. The mean length of stay in the hospital and intensive care unit (ICU) was 6.15 (SD=2.91) and 3.17 (SD=1.50) days, respectively. Of the participants, 90.9% had a cesarean section, 51.6% had emergency PPH, 88.2% had emergency PPH in 24 hours after delivery, 9.1% had an induction, and 60.6% had PPH due to placental abnormalities. The mean duration of PPH procedure was 2.51 (SD=1.14) hours. The most common post-operative complication in participants was fever. Participants with older gestational age had more elective PPH (P=0.029). The length of ICU stay was more in patients with total PPH procedure compared to the supracervical (P<0.017). The induction rate was higher in emergency PPH after vaginal delivery compared to cesarean section (P=0.005).
This study showed a high prevalence of PPH among pregnant women. Also, there was a significant relationship between the PPH and length of ICU stay, especially after supracervical hysterectomy. The results of this study can help obstetrician-gynecologist to provide a better intervention for managing patients with postpartum hemorrhage requiring PPH.
围产期子宫切除术（PPH）是一种有效的治疗方法，越来越多地用于挽救无法控制的产后大出血孕妇的生命。本研究的目的是评估伊朗孕妇中 PPH 的流行率和相关因素。
在一项回顾性研究中，我们招募了 33 名在伊朗北部马赞达兰省萨里的伊玛目霍梅尼医院接受 PPH 的孕妇。数据通过整群抽样收集，时间为 2017 年 3 月至 2020 年。收集患者的社会人口学和临床特征。Fisher 确切检验、Kruskal-Wallis 检验和 Mann-Whitney 检验用于评估研究变量。
伊朗孕妇中 PPH 的流行率为每 1000 例分娩 2.81 例。住院和重症监护病房（ICU）的平均住院时间分别为 6.15（SD=2.91）和 3.17（SD=1.50）天。参与者中，90.9%行剖宫产术，51.6%发生紧急 PPH，88.2%在分娩后 24 小时内发生紧急 PPH，9.1%引产，60.6%因胎盘异常发生 PPH。PPH 手术的平均持续时间为 2.51（SD=1.14）小时。参与者中最常见的术后并发症是发热。胎龄较大的患者行择期 PPH 更多（P=0.029）。与经宫颈子宫切除术相比，全子宫切除术的 ICU 住院时间更长（P<0.017）。与剖宫产术相比，阴道分娩后紧急 PPH 的引产率更高（P=0.005）。
本研究表明，孕妇 PPH 的流行率较高。此外，PPH 与 ICU 住院时间之间存在显著关系，尤其是在经宫颈子宫切除术后。本研究结果可以帮助妇产科医生更好地干预需要 PPH 的产后出血患者。
