[Hemostatic hysterectomy in modern obstetrics].
Haemostatic hysterectomies have been performed for the first time in the XIXth century to reduce the increased maternal mortality and associated morbidity. In Romania the main cause of death through direct obstetrical risk (DOR) is the haemorrhagic syndrome, with a value of 45% of the total number of deaths in the last 15 -16 years, a lot higher then the world average of 25% as evaluated by OMS. Among the deaths due to hemorrhagic syndrome 43% is held by antepartum haemorrhage (placenta praevia, utero-placental apoplexy) and 42% by postpartum haemorrhage.


RESULTS
In the past 15 years (1990 - 2005) there have been studied 53,870 births, out of which only 60 have had haemostatic hysterectomy, representing 0.11% of the total number of births. The prevalence of haemostatic hysterectomy is only 1 in every 883 births as a result of surgical teams' efforts to preserve the uterus. The placental pathology (30%) is responsible for most of haemostatic hysterectomy indications. Out of 60 cases under study, none ended with maternal death, while 11 cases ended with fetal death (intrapartum or postpartum).


CONCLUSIONS
Morbidity and maternal death can be reduced by effective prenatal care, by identifying high risk patients and by the possibility of caesarean section. Haemostatic hysterectomy remains, in essence, a life saving procedure!
Suciu
N
N
Clinica de Obstetrică-Ginecologie, Spitalul Clinic IOMC Polizu, Bucureşti.
Toader
Oana
O
Bănceanu
G
G
Ionescu
Mioara
M
Eşanu
S
S
Măgurean
Oana
O
Ilina
Dana
D
Iurco
Lucia
L
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D004638:Emergency Treatment / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality / Q000639:trends; D007744:Obstetric Labor Complications / Q000601:surgery; D010921:Placenta Accreta / Q000453:epidemiology / Q000601:surgery*; D010923:Placenta Previa / Q000453:epidemiology / Q000601:surgery*; D006473:Postpartum Hemorrhage / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D016019:Survival Analysis