Verma Manju Lata, Prasad Sonia, Mehrotra Seema, Sankhwar Pushp Lata, Jaiswar Shyam Pyari
Department of Obstetrics and Gynaecology, KGMU, Lucknow, India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):371-375. doi: 10.1007/s13224-024-02006-3. Epub 2024 Jun 18.
Peripartum hysterectomy is defined as removal of uterus at the time of delivery or in immediate postpartum period till 6 weeks. This study had been performed to critically evaluate the incidence, indications, maternal and neonatal morbidity and mortality associated with peripartum hysterectomies so that corrective measures both preventive and treatment may be implicated for benefit of women health.
A retrospective observational study in the Department of Obstetrics and Gynaecology, from 1st January 2013 to 31st December 2022, was conducted after obtaining ethical clearance. Information about all women, who had peripartum hysterectomy obtained from the medical case sheets, were recorded in a structured format which included demographic details, indication of peripartum hysterectomy, maternal and foetal outcome, per operative and postoperative complications, requirement of blood transfusion and need of ventilator support. Statistical analysis was done using the software package SPSS 28 for Windows.
Total 478 peripartum hysterectomies were performed during study duration. Incidence of peripartum hysterectomy at our centre was 6.4 per thousand deliveries. 45.8% (219/478) cases of peripartum hysterectomy had rupture uterus. Second most common cause was morbid adherent placenta which was in tune of 19%. Other causes were uterine atony, placenta previa and postpartum sepsis. 47.2% patients required ICU care, 1.25% had bladder injury, 10% had septicaemia, 0.8% required relaparotomy and 57.9% had still birth.
Although peripartum hysterectomy is uncommon procedure but it is lifesaving procedure so every obstetrician must have expertise in this procedure.
围产期子宫切除术定义为在分娩时或产后立即至6周内切除子宫。本研究旨在严格评估围产期子宫切除术的发生率、适应证、孕产妇和新生儿发病率及死亡率，以便采取预防和治疗的纠正措施，造福女性健康。
在获得伦理批准后，于2013年1月1日至2022年12月31日在妇产科进行了一项回顾性观察研究。从医疗病历中获取的所有接受围产期子宫切除术的女性信息，以结构化格式记录，包括人口统计学细节、围产期子宫切除术的适应证、孕产妇和胎儿结局、手术中和术后并发症、输血需求和呼吸机支持需求。使用Windows版SPSS 28软件包进行统计分析。
在研究期间共进行了478例围产期子宫切除术。我们中心围产期子宫切除术的发生率为每千例分娩6.4例。45.8%（219/478）的围产期子宫切除术病例发生子宫破裂。第二常见的原因是胎盘植入，占19%。其他原因包括子宫收缩乏力、前置胎盘和产后败血症。47.2%的患者需要重症监护，1.25%的患者发生膀胱损伤，10%的患者发生败血症，0.8%的患者需要再次剖腹手术，57.9%的患者发生死产。
虽然围产期子宫切除术是一种不常见的手术，但它是一种挽救生命的手术，因此每位产科医生都必须具备该手术的专业知识。
