[Obstetric hysterectomy. Incidence, indications and complications].
BACKGROUND
Obstetric hysterectomy is indicated when patient's life is at risk, and it is a procedure that requires a highly experienced and skilled medical team to solve any complication.


OBJECTIVE
To identify incidence, indications, and complications of obstetric hysterectomy within a high-risk population.


METHODS
Transversal, retrospective study from July 1st 2004 to June 30 2006 at Unidad Medica de Alta Especialidad, Hospital de Ginecoobstetricia, Centro Medico Nacional de Occidente, IMSS. There were reviewed 103 patient' files with obstetric hysterectomy. Incidence was calculated, and clinical and socio-demographic characteristics, indications, and complications of obstetric hysterectomy identified and expressed in frequency, percentages, and central tendency measurements.


RESULTS
Incidence of obstetric hysterectomy was 8 cases within every 1,000 obstetric consultation. Age average was 31.1 +/- 5.1 years. 72.8% had cesarean surgery history. Main indication was placenta previa associated with placenta accreta (33%), followed by uterine hypotony (22.3%). Complications were hypovolemic shock (56.3%), and vesical injuries (5.8%). There were no maternal deaths.


CONCLUSIONS
Cesarean history induces higher obstetric hysterectomy incidence in women with high-risk pregnancy, due to its relation to placentation disorders, as placenta previa that increases hemorrhage possibility, and thus, maternal morbidity and mortality.
Vázquez
Juan A Reveles
JA
Unidad Médica de Alta Especialidad, Hospital de Gincecoobstetricia, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, México.
Rivera
Geannyne Villegas
GV
Higareda
Salvador Hernández
SH
Páez
Fernando Grover
FG
Vega
Carmen C Hernández
CC
Segura
Agustin Patiño
AP
D000328:Adult; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D008800:Mexico; D007744:Obstetric Labor Complications / Q000601:surgery*; D010921:Placenta Accreta / Q000601:surgery; D010923:Placenta Previa / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006473:Postpartum Hemorrhage / Q000601:surgery; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012189:Retrospective Studies; D012307:Risk Factors; D012769:Shock / Q000453:epidemiology / Q000209:etiology; D001743:Urinary Bladder / Q000293:injuries; D014592:Uterine Hemorrhage / Q000209:etiology / Q000601:surgery*; D014593:Uterine Inertia / Q000601:surgery