Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Emergency peripartum hysterectomy  [PDF]
Mehmet S?dd?k Evsen,M. Erdal Sak,?zgür ?zkul,Ya?ar Bozkurt
Dicle Medical Journal , 2009,
Abstract: The aim of the present study was to determine the incidence, indications and maternal characteristics of emergency peripartum hysterectomy (EPH).Medical records belong to 49 patients, that undergone EPH at Diyarbak r Gynecology and Obstetrics Hospital, between September 2005 and August 2008 were retrospectively reviewed. During three years, from 63463 deliveries, hysterectomy was performed to 49 patients (0.77/1000) due to obstetrical hemorrhage. Indications for EPH were uterine atony (49.6%), uterine rupture (42.9%) and placenta accreata (8.2%). The mean age of patients was 34.6±5.7 years, and mean gravida was 5.5±2.4. Subtotal hysterectomy was performed to 31 (63.3%) patients and total hysterectomy to 18 (36.7%) of them. Bilateral hypogastric artery ligation was performed to 8 (16.3%) and unilateral ooferectomy to 7 (14.3%). Two of our patients died secondary to uncontrolled uterine bleeding.In conclusion, uterine atony and uterine rupture were the most frequent causes of EPH. Emergent and appropriate management of these patients is the most important life saving procedure.
Peripartum Hysterectomy in a Teaching Hospital in India  [PDF]
Swati Agrawal, Reena Yadav, Chitra Raghunandan, Shilpa Dhingra, Harvinder Kaur
Asian Journal of Medical Sciences , 2013, DOI: 10.3126/ajms.v4i1.6967
Abstract: Objectives: To find the incidence and clinical implications of peripartum hysterectomy in a tertiary care centre of India. Methods: A retrospective study of all cases of caesarean and postpartum hysterectomy between January 2006 and December 2011. Maternal characteristics, method of delivery, indications for hysterectomy and complications were reviewed. Results: The rate of peripartum hysterectomy was 0.47:1000 deliveries. Most were operative deliveries. The main indications were placenta accreta (38.88%), massive atonic PPH (36.11%) and uterine rupture (22.22%). Half the hysterectomies were subtotal while the rest were total. Maternal morbidity was high and there were seven maternal deaths (19.44%). All deaths were in patients brought in a critical condition to the hospital after massive blood loss. Conclusion: Peripartum hysterectomy is potentially a life saving procedure but the mortality and morbidity is high, especially if performed late when the hemodynamic instability has already set in. DOI: http://dx.doi.org/10.3126/ajms.v4i1.6967 Asian Journal of Medical Sciences 4(2013) 5-9
Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year review
NJA Obiechina, GU Eleje, IU Ezebialu, CAF Okeke, SU Mbamara
Nigerian Journal of Clinical Practice , 2012,
Abstract: Background: Emergency peripartum hysterectomy has remained a challenging and very life saving surgical procedure in obstetrics. Its indications are emerging. Aims: This was to determine the incidence, indications, and outcomes of emergency peripartum hysterectomy at a tertiary hospital in Nnewi, south–east Nigeria. Materials and Methods: A retrospective study of the case files of patients requiring an emergency peripartum hysterectomy between January 2000 and December 2009 was conducted. Emergency peripartum hysterectomy was defined as one performed for hemorrhage unresponsive to other treatment within 24 hours of delivery. The findings were analyzed using Epi info version 3.5.1. Results: During the 10-year period, there were 6,137 deliveries and 38 cases of emergency peripartum hysterectomies, giving an incidence of 6.2 per 1000 deliveries. Of the 38 hysterectomies, only 29 (76.3%) case files were available for analysis. The mean age of the patients was 28.1 ± 5.4 years and 22 (75.9%) patients were unbooked. There were four primigravidae (13.8%) while 25 (86.2%) were parous. The main indications for hysterectomy were placenta praevia 14 (48.3%) and uterine rupture 10 (34.5%). Subtotal hysterectomy was performed in majority (72.4%) of cases. The commonest postoperative morbidities were postoperative fever (37.9%), postoperative anemia (24.1%), and wound infection (20.7%). The maternal case fatality rate was 31.0%, while the perinatal mortality was 44.8%. The mean duration of hospital stay was 9.8 ± 2.4 days. Conclusion: The incidence of emergency peripartum hysterectomy was high and majority of patients were unbooked. Placenta praevia has emerged as its primary indication. Booking for antenatal care, anticipation, prompt resuscitation, and early surgical intervention by a skilled surgeon are crucial.
Trends in the Rates of Peripartum Hysterectomy and Uterine Artery Embolization  [PDF]
Geum Joon Cho, Log Young Kim, Hye-Ri Hong, Chang Eun Lee, Soon-Cheol Hong, Min-Jeong Oh, Hai-Joong Kim
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0060512
Abstract: The objective of this study was to determine the trends in national rates of peripartum hysterectomy (PH) and uterine arterial embolization (UAE) in Korea. We used data collected by the Health Insurance Review & Assessment Service of Korea and analyzed data from patients who gave birth during the period from 2005 to 2008. There were 1785,178 deliveries during the study period, including 2636 cases of PH (1.48 per 1000 deliveries). The PH rate in 2005 was 1.57 per 1000 deliveries and in 2008 it was 1.33 per 1000 deliveries. UAE was performed in 161 women (incidence, 0.38 per 1000 deliveries) and 447 women (incidence, 0.98 per 1000 deliveries) in 2005 and 2008, respectively. In Korea, the rate of PH decreased slightly, while the rate of UAE rate increased dramatically during the period from 2005 to 2008. Further studies are needed to evaluate the effects of UAE on the rate of PH performed.
Peripartum Hysterectomy in Misan Province during 2014-2016  [PDF]
Saba J. Al Heshemi
Open Journal of Obstetrics and Gynecology (OJOG) , 2017, DOI: 10.4236/ojog.2017.72028
Abstract: Background: Peripartum hysterectomy is the procedure of removing the uterus after vaginal delivery or cesarean birth; it remains a life-saving procedure in cases of severe uterine hemorrhage. Objective: To know the incidence of peripartum hysterectomy in Misan province, what is the main cause of this procedure, and if there is any change in the incidence of this procedure during a 3 year study period. Method: A descriptive cross sectional study was done in Misan province for all cases of peripartum hysterectomy during the period from 2014-2016. All information regarding present pregnancy, previous obstetric history, the cause of peripartum hysterectomy, any complications & infant outcome, were taken from the case sheet & from the patients themselves. 50 patients were enrolled in this study, and only 30 patients needed peripartum hysterectomy and 20 patients’ uterus were saved by repair surgery. Results: During the study period of 3 years, there was 72,720 deliveries, and during that time 30 peripartum hysterectomies were carried out of the 50 cases studied, which gave an incidence of 0.4/1000 deliveries. The patients were diagnosed as: rupture uterus in 30 (60%) cases, adherent placenta in 14 (28%) & 6 (12%) cases had atonic uterus. The major postoperative complication was anemia which complicated 23 (46%) cases, & then bladder injury 5 (10%). Admission to ICU was needed for 24 (48%) cases. There were 32 (64%) cases needed ≥4 units of blood transfusion. There were 38 (76%) cases stayed in hospital for ≥4 days. The most common cause for peripartum hysterectomy was for adherent placenta (28%) & rupture uterus (20%). Conclusion: The incidence of peripartum hysterectomy was 0.4/1000 (0.04%) deliveries. The most common reason behind peripartum hysterectomy was for adherent placenta and next was for uterine rupture. The rate of this procedure was not changed during the study period.
Anaesthetic challenges in emergency peripartum hysterectomy in West Africa: a Nigerian perspective
UV Okafor, HU Ezegwui, O Okezie
Southern African Journal of Anaesthesia and Analgesia , 2010,
Abstract: Background: To determine the foeto-maternal outcome and the anaesthetic challenges in emergency peripartum hysterectomy at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Method: A retrospective study was carried out on parturients that had had emergency peripartum hysterectomy at UNTH in Nigeria, from July 1998 to June 2006. Data collected included demographics, anaesthetic and obstetric records, foeto-maternal outcomes and the need for critical care management. Results: There were a total of 6 798 deliveries and 6 485 live births, with 16 emergency peripartum hysterectomies. The incidence of emergency peripartum hysterectomy was 0.23% of all deliveries (2.3/1 000 deliveries). The causes of emergency hysterectomies were ruptured uterus (11 patients or 69%), placenta accreta/morbidly adherent placenta (4 patients or 25%) and uncontrollable postpartum haemorrhage following vaginal delivery (1 patient or 6%). Eight patients had subtotal hysterectomy, while eight had total abdominal hysterectomy (TAH). All the patients received general anaesthesia and blood transfusion. There were two postoperative admissions to the intensive care unit (ICU) and two procedure-related deaths due to hypovolaemic shock. There were nine stillbirths but no documented neonatal deaths. Conclusion: Emergency peripartum hysterectomies challenge the anaesthetist and the obstetrician who have to maintain haemodynamic stability in patients who may have lost volumes of blood, in a setting where blood and colloid availability is often limited. The maternal mortality was higher than that of most of the studies reviewed.
Obstetric Hysterectomy and Maternal Survival  [PDF]
J Baral,G Gurung,A Rana,B Manandhar,R Manandhar,J Sharma
Nepal Journal of Obstetrics and Gynaecology , 2014, DOI: 10.3126/njog.v9i2.11759
Abstract: Aims: This study was done to analyze the cases of obstetric hysterectomy and maternal complications and survival after that. Methods: A retrospective study was carried out from the review of records ??of the near miss, maternal mortality, cesarean audit and operation theater record of the Department of Obstetrics and Gynaecology, Tribhuvan University Teaching Hospital (TUTH), Kathmandu from 2057-2071 BS. Results: Fourteen maternal survival resulted following total of 19 obstetric hysterectomy, subtotal hysterectomy being the procedure of choice in 11 cases, emergency peripartum hysterectomy (EPH) being performed in abundance (18/19) in comparison to an elective peripartum hysterectomy, which was undertaken in a single case of placenta percreta, and inclusive of latter were four cases of morbid placental adhesion, a placenta increta and two placenta accreta. Eight out of 19 cases had vaginal delivery and rest had cesarean section. Among seven cases of cesarean hysterectomy 3 were done for placenta previa with accreta one case each done for abruptio placentae? and placenta accreta and two cases were done for extra placental causes. Among four cases of emergency peripartum hysterectomy (EPH), which were relaparotomy followed by hysterectomy, three cases were done for complication of cesarean section and one done for uterine atonicity. Four cases of spontaneous vaginal deliveries needed peripartum hysterectomy two of them were complicated by morbid placental adhesion placenta increta (1), placental percreta (1), two cases were vaginal birth after cesarean (VBAC). Seven cases of uterine rupture had undergone peripartum hysterectomy.?? Conclusions : Obstetric hysterectomy is a lifesaving surgical procedure for maternal survival whenever necessary and mandates a quick decision making process, however in consideration of younger age and low parity or nulliparity, the best obstetric governance and services must foresee not to let mothers meet such situation necessitating organ removal and to enjoy potential reproductive life cycle. DOI: http://dx.doi.org/10.3126/njog.v9i2.11759 ? ?
The Possible Correlation between the Patient's Immune Tolerance Level During Cesaerean Section and the Incidence of Subsequent Emergency Peripartum Hysterectomy  [PDF]
Lukasz Wicherek,Krystna Galazka
Clinical and Developmental Immunology , 2007, DOI: 10.1155/2007/63596
Abstract: Introduction. Cesarean section is an independent risk factor for peripartum hysterectomy. As a method of delivery, cesarean section may interfere with a number of molecular changes that occur at the maternal-fetal interface during the course of labor. Methods. The level of CD3, CD56, CD25, and CD69 antigen immunoreactivity was assessed by immunohistochemistry in 26 decidual tissue samples. The tissue samples were obtained from 18 women who underwent cesarean sections at term and from 8 women who underwent cesarean hysterectomies. Results. An increase in the activity and infiltration of immune cells in the decidua sampled during the spontaneous beginning of labor was observed. The further progression of labor was accompanied by a decrease in the number and activity of immune cells. The number of CD56
Supracervical hysterectomy versus total abdominal hysterectomy: perceived effects on sexual function
Jyot Saini, Edward Kuczynski, Herbert F Gretz, E Scott Sills
BMC Women's Health , 2002, DOI: 10.1186/1472-6874-2-1
Abstract: A retrospective chart review was performed to identify all patients who underwent supracervical hysterectomy or total abdominal hysterectomy at a tertiary care center. Patients who met criteria for participation were sent a one page confidential, anonymous questionnaire to assess sexual function experienced both pre- and postoperatively. A total of 69 patients in each group were eligible for participation. A multiple logistic regression model was used to analyze measured variables.Forty-eight percent (n = 33) of women undergoing a SCH returned the questionnaire, while 39% (n = 27) of those undergoing a TAH chose to participate. There were no significant demographic differences between the two groups. Patients who underwent TAH reported worse postoperative sexual outcome than SCH patients with respect to intercourse frequency, orgasm frequency and overall sexual satisfaction (P = 0.01, 0.03, and 0.03, respectively). Irrespective of type of hysterectomy, 35% of patients who underwent bilateral salpingoophorectomy (BSO) with hysterectomy experienced worse overall sexual satisfaction compared to 3% of patients who underwent hysterectomy alone (P = 0.02).Our data suggest that TAH patients experienced worse postoperative sexual function than SCH patients with respect to intercourse frequency and overall sexual satisfaction. Irrespective of type of hysterectomy, patients who underwent bilateral salpingoophorectomy experienced worse overall sexual satisfaction.Hysterectomy is the most common gynecologic operation performed in the United States. It is estimated that by the age of 65, 1 of 3 women will have undergone a hysterectomy [1,2]. Current practice in the United States strongly favors total abdominal hysterectomy (TAH) over supracervical hysterectomy (SCH) for benign gynecologic disease. However, there has been a small but steady rise in the number of supracervical hysterectomies performed both regionally and nationally [3,4]. The reasons for this shift in hysterectomy
The Professional Medical Journal , 2006,
Abstract: Objective: A study was conducted to evaluate the benefits of vaginal hysterectomy versus abdominalhysterectomy in patient with minimal or no prolapse, no pelvic adhesions and size of uterus not larger than 10 weeksof gestation. Design: A retrospective study. Setting: The study was conducted at Department of Obstetrics andGyanecology , Services Hospital Lahore. Subject And Method: Total of 70 cases were included out of which 40 werevaginal and 30 were abdominal hysterectomies. Results: In vaginal group the morbidity was less, no abdominal scar,shorter hospital stay and less socioeconomic burden on the patient. Conclusion: The conclusion made was vaginalprocedure is method of choice when ever applicable.
Page 1 /100
Display every page Item

Copyright © 2008-2017 Open Access Library. All rights reserved.