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9-EMERGENCY PERIPARTUM HYSTERECTOMY: EXPERIENCE AT BASRAH MATERNITY AND CHILDREN HOSPITAL

Haifa Al-Shaheen

Basrah Journal of Surgery مجلة البصرة الجراحية
ISSN: 16833589 Year: 2009 Volume: 15 Issue: 2 Pages: 56-63
Publisher: Basrah University جامعة البصرة

Abstract

To estimate the incidence, indications, risk factors and complications associated with emergency peripartumhysterectomy, we analyzed retrospectively all cases of emergency peripartum hysterectomy performedat Basrah Maternity and Children from 1st of January 2005 to 31st of December 2007. Emergencyperipartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatmentless than 24 hours after delivery. There were 20 emergency peripartum hysterectomy among 51,121deliveries for a rate of 0.3/1000. Fifteen women (75%) were delivered by caesarean delivery. Eighteenwomen were multiparous and 2 were primiparous. Most frequent indications were placenta accrete (60%),9 with praevia and 3 with out praevia), followed by uterine atony in (20%), uterine rupture in (10%),extended cervical tear in (5%), and retroperitoneal haematoma in 5%.Placenta accreta was the most common indication in multiparous women (66.6%, 12 of 18) while uterineatony was the most common in primiparous.Eleven out of 12 (91.7%) women with placenta accrete had a previous caesarean delivery. Three (25%)had a previous one caesarean section and 8 (66.6%) women had .2 previous caesarean section. Fourteen(70%) of hysterectomies were subtotal. Intraopeartive complications were (15%) and Postoperativefebrile morbidity was (60%).We concluded that placenta accreta has become the most common indicationfor emergency peripartum hysterectomy. The number of caesarean deliveries increased the risk ofplacenta accreta proportionally.

Keywords

HYSTERECTOMYASES --- PERIPARTUM