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Emergency peripartum hysterectomy: A great obstetric challenge
OBJECTIVE: To determine the prevalence, etiology and complications of emergency obstetric hysterectomy (EOH) at a tertiary care hospital in Karachi. METHODS: This was a retrospective cohort study which was carried out in the Department of Obstetrics & Gynecology Unit II, Civil Hospital Karachi f...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Professional Medical Publications
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290222/ https://www.ncbi.nlm.nih.gov/pubmed/30559824 http://dx.doi.org/10.12669/pjms.346.13686 |
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author | Kazi, Sarah |
author_facet | Kazi, Sarah |
author_sort | Kazi, Sarah |
collection | PubMed |
description | OBJECTIVE: To determine the prevalence, etiology and complications of emergency obstetric hysterectomy (EOH) at a tertiary care hospital in Karachi. METHODS: This was a retrospective cohort study which was carried out in the Department of Obstetrics & Gynecology Unit II, Civil Hospital Karachi from March 2015 to March 2017. All patients undergoing EOH were included in the study. Data was collected from medical files and labor room registers in accordance with ethical guidelines. Information included demographic characteristics, reasons for EOH, procedure associated morbidity and mortality. Data was recorded on a predesigned pro forma and analyzed using IBM SPSS Statistics for Macintosh, Version 18.0. RESULTS: Out of 7,968 deliveries in two years, 32 patients under went EOH, (prevalence 4.01 per 1,000 deliveries). The mean age was 30.0 ± 5.2 years. Most women (75%) were multipara. The main mode of delivery was caesarean section (80%), mostly done as an emergency procedure (81%). In 10(30%) patients EOH was performed for uncontrollable hemorrhage due to uterine atony, followed by a morbidly adherent placenta (28%). Morbidity included disseminated intravascular coagulation (DIC) in four patients(19%) and three patients underwent repeat laparotomy for uncontrollable hemorrhage. There were three maternal deaths, giving a case-fatality index of 9.3%. CONCLUSION: Uterine atony and morbidly adherent placenta were the main reasons for emergency obstetric hysterectomy (EOH) in our set up. |
format | Online Article Text |
id | pubmed-6290222 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Professional Medical Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-62902222018-12-17 Emergency peripartum hysterectomy: A great obstetric challenge Kazi, Sarah Pak J Med Sci Original Article OBJECTIVE: To determine the prevalence, etiology and complications of emergency obstetric hysterectomy (EOH) at a tertiary care hospital in Karachi. METHODS: This was a retrospective cohort study which was carried out in the Department of Obstetrics & Gynecology Unit II, Civil Hospital Karachi from March 2015 to March 2017. All patients undergoing EOH were included in the study. Data was collected from medical files and labor room registers in accordance with ethical guidelines. Information included demographic characteristics, reasons for EOH, procedure associated morbidity and mortality. Data was recorded on a predesigned pro forma and analyzed using IBM SPSS Statistics for Macintosh, Version 18.0. RESULTS: Out of 7,968 deliveries in two years, 32 patients under went EOH, (prevalence 4.01 per 1,000 deliveries). The mean age was 30.0 ± 5.2 years. Most women (75%) were multipara. The main mode of delivery was caesarean section (80%), mostly done as an emergency procedure (81%). In 10(30%) patients EOH was performed for uncontrollable hemorrhage due to uterine atony, followed by a morbidly adherent placenta (28%). Morbidity included disseminated intravascular coagulation (DIC) in four patients(19%) and three patients underwent repeat laparotomy for uncontrollable hemorrhage. There were three maternal deaths, giving a case-fatality index of 9.3%. CONCLUSION: Uterine atony and morbidly adherent placenta were the main reasons for emergency obstetric hysterectomy (EOH) in our set up. Professional Medical Publications 2018 /pmc/articles/PMC6290222/ /pubmed/30559824 http://dx.doi.org/10.12669/pjms.346.13686 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kazi, Sarah Emergency peripartum hysterectomy: A great obstetric challenge |
title | Emergency peripartum hysterectomy: A great obstetric challenge |
title_full | Emergency peripartum hysterectomy: A great obstetric challenge |
title_fullStr | Emergency peripartum hysterectomy: A great obstetric challenge |
title_full_unstemmed | Emergency peripartum hysterectomy: A great obstetric challenge |
title_short | Emergency peripartum hysterectomy: A great obstetric challenge |
title_sort | emergency peripartum hysterectomy: a great obstetric challenge |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6290222/ https://www.ncbi.nlm.nih.gov/pubmed/30559824 http://dx.doi.org/10.12669/pjms.346.13686 |
work_keys_str_mv | AT kazisarah emergencyperipartumhysterectomyagreatobstetricchallenge |