紧急围产期子宫切除术及相关危险因素。

Emergency peripartum hysterectomy and associated risk factors.

作者信息

Stanco L M, Schrimmer D B, Paul R H, Mishell D R

机构信息

Department of Obstetrics and Gynecology, University of Southern California, Los Angeles.

出版信息

Am J Obstet Gynecol. 1993 Mar;168(3 Pt 1):879-83. doi: 10.1016/s0002-9378(12)90838-8.

DOI:10.1016/s0002-9378(12)90838-8

PMID:8456896

Abstract

OBJECTIVE

Peripartum hysterectomy at Los Angeles County-University of Southern California Medical Center was reviewed and associated risk factors were identified.

STUDY DESIGN

Retrospective descriptive and cohort analysis from January 1985 to June 1990 was carried out. Adjusted relative risks for hysterectomy with 95% confidence intervals for identified risk factors were calculated where possible.

RESULTS

There were 123 cases of emergency peripartum hysterectomy (incidence of 1.3/1000 births). Indications for hysterectomy were primarily placenta accreta (n = 61), uterine atony (n = 25), unspecified uterine bleeding (n = 19), and uterine rupture (n = 14). The relative risk of emergency hysterectomy was 95.5 (95% confidence interval 66.7 to 136.9) for cesarean delivery, 10.78 (95% confidence interval 7.56 to 15.37) for prior cesarean delivery, and 97.29 (95% confidence interval 70.28 to 134.70) for placenta previa.

CONCLUSIONS

Cesarean delivery, prior cesarean delivery, placenta previa, placenta accreta, and uterine atony were identified risk factors for emergency peripartum hysterectomy.

摘要

目的

回顾洛杉矶县南加州大学医学中心的围产期子宫切除术，并确定相关危险因素。

研究设计

对1985年1月至1990年6月进行回顾性描述性和队列分析。尽可能计算已确定危险因素的子宫切除术调整相对风险及95%置信区间。

结果

有123例急诊围产期子宫切除术（发生率为1.3/1000次分娩）。子宫切除术的指征主要是胎盘植入（n = 61）、子宫收缩乏力（n = 25）、未明确的子宫出血（n = 19）和子宫破裂（n = 14）。剖宫产急诊子宫切除术的相对风险为95.5（95%置信区间66.7至136.9），既往剖宫产史为10.78（95%置信区间7.56至15.37），前置胎盘为97.29（95%置信区间70.28至134.70）。