Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
-
Amelie de Gregorio
,
Thomas W.P. Friedl
Abstract
Background
Peripartal hysterectomy (PH) is a challenging surgical procedure with elevated maternal morbidity.
Methods
From 2004 to 2016, 41 emergency PHs were performed at the tertiary care center of the Department of Gynecology and Obstetrics at University Hospital Ulm. In our retrospective analysis, the incidence of PH in our hospital was 12.8 per 10,000 deliveries with a maternal mortality of 2.4%. PH followed in 80.5% after cesarean section (c-section). Underlying causes/indications for PH were abnormal placentation (53.7%; n=22), uterine atony (26.8%; n=11), uterine lacerations (14.6%; n=6) and in rare cases uterine infection (4.9%; n=2). The median number of transfused products was 11 packed red blood cells (range 0–55 products), 10 fresh frozen plasma units (range 1–43) and two platelet concentrates (0–16).
Results
Loss of blood as estimated by surgeons was significantly correlated with actual transfused blood volume (P<0.001). Clinically relevant intra- and/or postoperative complications occurred in 53.7% of patients (n=22). Abnormal placentation was the leading cause for PH with an increased incidence during the last 10 years presumptively representing the elevated rate of c-sections.
Conclusion
PH goes along with increased rates of blood product transfusions independently of indication for surgery and has a high morbidity with a major complication rate of more than 50%. Prepartal assessment of risk factors like abnormal invasive placenta are crucial for reducing maternal morbidity.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2018-0149).
©2019 Walter de Gruyter GmbH, Berlin/Boston
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Ultrasound Doppler waveform assessment: the story continues
- Review
- Association between increased antenatal vaginal pH and preterm birth rate: a systematic review
- Mini Review
- Update on uterine tachysystole
- Research Articles – Obstetrics
- First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study
- Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
- Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
- Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
- Effect of dual tocolysis with fenoterol and atosiban in human myometrium
- Antecedents of red cell transfusion in a large contemporary obstetric cohort
- Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
- Research Articles – Fetus
- Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy
- Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
- Doppler evaluation of the fetal pulmonary artery pressure
- Mechanisms of death in structurally normal stillbirths
- The diagnostic value of a detailed first trimester anomaly scan in fetuses with increased nuchal translucency thickness
- Research Articles – Newborn
- Small for gestational age and extremely low birth weight infant outcomes
- Does heart rate variability improve prediction of failed extubation in preterm infants?
