Emergency obstetric hysterectomy.
A population-based review (1988-2000) of 142,634 deliveries found an incidence of emergency obstetric hysterectomy of 0.53 per 1000 deliveries. The relative risk for caesarean versus vaginal delivery was 18.32 (10.26, 32.71) P<0.001. Previous caesarean delivery occurred in 47.4% and 22.4% were primiparous. Causes and morbidity were ascertained in a hospital-based study (1980-2001) of 64 emergency hysterectomies in 110,537 deliveries. The main indications for hysterectomy were abnormal placentation (50%) and atonic postpartum haemorrhage (32.8%). Blood transfusion was needed in 84.4% and intensive care in 26.6%. There were no maternal deaths. Potential alternatives to hysterectomy for massive obstetric haemorrhage are discussed.
Baskett
T F
TF
Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, Nova Scotia, Canada.
D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D049590:Postpartum Period; D011247:Pregnancy