title: Breastfeeding following emergency peripartum hysterectomy.
abstract: Emergency peripartum hysterectomy (EPH) is usually performed in cases of intractable obstetric hemorrhage unresponsive to conservative treatment. EPH is associated with a high incidence of maternal morbidity and mortality. Most of these women do not have the opportunity to even start breastfeeding. We report a case where breastfeeding was attempted after EPH. The mother spent 6 days in the intensive care unit and suffered several medical and surgical complications. On day 7 she was reunited with her baby. One month later, a diagnosis of post-traumatic stress disorder was made. Breastfeeding became very important, with the patient frequently expressing that this was the most healing aspect in her recovery from the traumatic EPH. At 3 months, five daily feeds were supplemented with formula. Breastfeeding, principally nocturnal, continued 6 months after childbirth, with the baby being weaned at 7 months. Women who undergo EPH need psychological support. The option of breastfeeding should be considered even days or weeks after the surgical intervention as it can be a healing experience for some women who are grieving the loss of their fertility. Professional specialized breastfeeding support should be offered in these cases, and the possibility of reuniting mother and infant even when the mother is in the intensive care unit should be considered.
authors.affiliation: Department of Psychiatry, Autonomous University of Madrid, Madrid, Spain. ibone.olza@salud.madrid.org
authors.forename: Ibone
authors.initials: I
authors.lastname: Olza-Fernández
authors.forename: Lourdes
authors.initials: L
authors.lastname: García-Murillo
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Palanca-Maresca
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D001942:Breast Feeding / Q000379:methods / Q000523:psychology*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods / Q000523:psychology* / Q000534:rehabilitation; D007231:Infant, Newborn; D009034:Mother-Child Relations; D058725:Peripartum Period; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D016896:Treatment Outcome; D014592:Uterine Hemorrhage / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery*