Majallah-i Dānishgāh-i ̒Ulūm-i Pizishkī-i Bābul (Jul 2013)
Emergency Peripartum Hysterectomy in North of Iran
Abstract
BACKGROUND AND OBJECTIVE: Emergency peripartum hysterectomy (EPH) is a major surgery that usually performs in severe and life threatening bleeding after vaginal or cesarean delivery. Since, maternal morbidity and mortality is important in health system of our country so we studied incidence, indications, risk factors and complications of this surgery in pregnant women undergoing emergency peripartum hysterectomy at the hospitals of Babol University of medical sciences during 10 years.METHODS: This cross-sectional study was performed on pregnant women undergoing emergency peripartum hysterectomy in Shahid Yahyanejad and Ayatollah Roohani hospitals of Babol, Iran during 2002-2011. Data such as demographic data, type of delivery and hysterectomy, amount of blood transfusion, days of hospitalization, maternal and neonatal morbidity and mortality were gathered and the results were analyzed.FINDINGS: Twenty two EPH cases were identified among 37595 deliveries giving an incidence of 0.5 per 1000 deliveries that its rate in cesarean section delivery was 0.7 per 1000 and in vaginal delivery was 0.2 per 1000. The most indications of peripartum hysterectomy were 8 cases with uterine atony (36.4%) and 6 cases with abnormal placentation (27.3%), and the cesarean section and curettage were major risk factors for abnormal placentation. Blood transfusion was performed in all of patients and intra and postoperative complications included: 11 cases (84.6%) with intensive care admission that 5 cases (38.5%) of them had febrile morbidity and also 2 cases (15.2%) of them had vesical and urethral injury. There was 3 (13.6%) maternal death due to hemorrhagic shock. CONCLUSION: According to the results of this study, incidence of EPH in our study was more in cesarean section than vaginal delivery and history of previous cesarean section and curettage were the risk factors for abnormal placentation.
