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三级医疗中心产科子宫切除术的临床审计:一项观察性回顾性研究。

Clinical Audit of Obstetric Hysterectomy in a Tertiary Care Centre: An Observational Retroprospective Study.

作者信息

Thakur Harshada S, Yadav Kavita, Mali Kimaya A, Saxena Akriti A

机构信息

Department of Obstetrics and Gynaecology, Seth GSMC and KEMH, Mumbai, Maharashtra India.

出版信息

J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):392-398. doi: 10.1007/s13224-024-02010-7. Epub 2024 Jul 13.

Abstract

PURPOSE OF STUDY

The purpose of this study is to analyse the profile and characteristics of patients who may undergo obstetric hysterectomy, to study the intra-operative and post-operative complications of these patients and to increase the preparedness and reduce morbidity and mortality of patients undergoing obstetric hysterectomy.

METHODS

After taking approval of the IEC, data of patients who had consented to be a part of the study were collected and analysed.

RESULTS

Our study included 30 patients. Twenty-two patients underwent emergency obstetric hysterectomy, with abnormal placentation being the most common indication followed by post-partum haemorrhage. The most common postoperative complication was bladder injuries, and two out of 30 patients eventually succumbed in the post operative period.

CONCLUSION

Most of the morbidity associated with OH is attributed to the indications for which OH is done rather than the procedure itself. The indication for obstetric hysterectomy has changed to abnormal placentation from uterine atony and rupture. Future studies and change in management practices should focus on reducing the rate of caesarean sections whenever possible with proper preoperative planning, designing appropriate labour unit protocols and setting up multi-disciplinary units to manage difficult cases.

摘要

研究目的

本研究旨在分析可能接受产科子宫切除术的患者的概况和特征,研究这些患者的术中及术后并发症,并提高接受产科子宫切除术患者的准备程度,降低其发病率和死亡率。

方法

在获得独立伦理委员会(IEC)批准后,收集并分析了同意参与本研究的患者的数据。

结果

我们的研究纳入了30例患者。22例患者接受了急诊产科子宫切除术,胎盘异常是最常见的指征,其次是产后出血。最常见的术后并发症是膀胱损伤,30例患者中有2例最终在术后死亡。

结论

与产科子宫切除术相关的大多数发病率归因于进行该手术的指征,而非手术本身。产科子宫切除术的指征已从子宫收缩乏力和子宫破裂转变为胎盘异常。未来的研究和管理实践的改变应尽可能专注于通过适当的术前规划、设计合适的产房协议以及建立多学科团队来管理疑难病例,以降低剖宫产率。

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