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首页> 外文期刊>Khyber Medical University Journal >PERIPARTUM HYSTERECTOMY; FREQUENCY, RISK FACTORS AND MATERNAL OUTCOME
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PERIPARTUM HYSTERECTOMY; FREQUENCY, RISK FACTORS AND MATERNAL OUTCOME

机译：腹膜子宫切除术;频率，风险因素和材料结果

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OBJECTIVE: To observe the frequency, indications and maternaloutcome associated with peripartum obstetrical hysterectomy andto explore the preventable factors contributing towards the adverseoutcome.METHODOLOGY: This cross-sectional descriptive observational studywas conducted at Women and Children Teaching Hospital, Bannu andincluded all the patients who underwent peripartum hysterectomy dueto obstetrical complication from 1st Jan 2009 to 30th June 2010. Clinicaland socio-demographic data was collected for analysis.RESULTS: During the study period, 4583 deliveries were conductedand peripartum hysterectomies were performed in 34 (0.74%) patients.Uterine rupture was the commonest indication (62%) and there wasno specific preference found for any type of hysterectomy. Most ofthe subjects were transfused more than three units of blood and 40%developed either acute potentially fatal or long term debilitating complications?while the case fatality rate (CFR) was 2.9%. Grandmultiparity?(n=24, 70.59%), previous or current cesarean section (n=22, 64.71%)?and injudicious use of uterotonics during labour (n=21, 61.76%) were?the common risk factors associated with peripartum hysterectomies and?their morbidities. Shock (n=20, 58.82%), disseminated intravascular?coagulation (n=5, 14.70%) and urinary tract injury (n=5, 14.70%) were?the commonest complications.CONCLUSION: Peripartum hysterectomies, performed in 1% deliveriesin our set up, are commonly performed for uterine rupture, withCFR of 2.9%. Grandmultiparity and previous or current cesarean sectionare common risk factors and shock is the commonest complication ofperipartum hysterectomy. Regular training and clinical audit of birthattendants to prevent prolonged obstructed labor or hyperstimulationof uterus may reduce this complication.KEY WORDS: Peripartum hysterectomy, Uterine rupture, Postpartumhaemorrhage, maternal morbidity, maternal mortality.
机译：目的：观察与围产期产科子宫切除术相关的频率，适应症和母体结局，并探讨导致不良结局的可预防因素。 2009年1月1日至2010年6月30日因产科并发症而行子宫切除术。收集临床和社会人口学资料进行分析。结果：在研究期间，对34例（0.74％）患者进行了4583例分娩，并进行了围产期子宫切除术。最常见的适应症（62％），对于任何类型的子宫切除术都没有发现特别的偏爱。大多数受试者输血超过三个单位，其中40％发生了急性潜在致命或长期使人衰弱的并发症，而病死率（CFR）为2.9％。产前检查（n = 24，70.59％），既往或当前剖宫产（n = 22，64.71％）和分娩时子宫内避孕药使用不当（n = 21，61.76％）是与围产期子宫切除术相关的常见危险因素和他们的发病率。休克（n = 20，58.82％），弥散性血管内凝血（n = 5，14.70％）和尿路损伤（n = 5，14.70％）是最常见的并发症。结论：围产期子宫切除术的发生率<1％在我们的机构中​​，通常是在子宫破裂时进行分娩，CFR为2.9％。巨大多胎和先前或当前的剖宫产是常见的危险因素，休克是围产期子宫切除术最常见的并发症。定期培训和对接生员进行临床检查以防止长时间的分娩或子宫过度刺激可以减少这种并发症。关键词：围产期子宫切除术，子宫破裂，产后出血，产妇发病率，产妇死亡率。

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