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Clinical and Experimental Obstetrics & Gynecology  2014, Vol. 41 Issue (6): 654-658    DOI: 10.12891/ceog17592014
Original Research Previous articles | Next articles
Clinical analysis of emergency peripartum hysterectomies in a tertiary center
M. Sakinci1, *(), O. Kuru2, M. Tosun3, A. Karagoz3, H. Celik3, F.D. Bildircin3, E. Malatyalioglu3
1Department of Obstetrics and Gynecology, Akdeniz University Medical Faculty, Antalya
2Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Teaching and Research Hospital, Istanbul
3Department of Obstetrics and Gynecology, Ondokuz Mayıs University Medical Faculty, Samsun (Turkey)
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Abstract  
Objective: To investigate the incidence, indications, complications, and risk factors associated with increased mortality and morbidity of emergency peripartum hysterectomy (EPH). Materials and Methods: The authors retrospectively analyzed 48 cases of EPH performed within six-year interval at Ondokuz Mayıs University Hospital. EPH was defined as the operation performed for life-threatening hemorrhage which could not be controlled with conservative treatment modalities within 24 hours of a delivery. Results: The incidence of EPH was 5.03 per 1,000 deliveries. The most common indication for EPH was abnormal placental adherence (n = 22, 45.8%), followed by uterine atony (n = 19, 39.6%). All the patients with placenta accreta had a history of repeat cesarian section (CS) and placenta previa. Total hysterectomy was performed in almost all of the patients (n = 47, 97.9%). All women required blood transfusions. Maternal morbidity was significant, with bladder injury (31.3%) and disseminated intravascular coagulation (18.7%) among the most common complications. There were one maternal (2.1%) and five neonatal deaths (10.4%). Conclusion: Since most of the EPH cases are associated with prior cesarean delivery, decision of the first CS should be made for true obstetrical indications. If conservative treatments fail to control massive obstetrical bleeding, blood products and an experienced obstetrician should be ready to perform EPH to decrease the maternal morbidity and mortality.
Key words:  Emergency peripartum hysterectomy      Placenta accreta      Uterine atony     
Published:  10 December 2014     
*Corresponding Author(s):  M. SAKINCI     E-mail:  mehmetsakinci@hotmail.com

Cite this article: 

M. Sakinci, O. Kuru, M. Tosun, A. Karagoz, H. Celik, F.D. Bildircin, E. Malatyalioglu. Clinical analysis of emergency peripartum hysterectomies in a tertiary center. Clinical and Experimental Obstetrics & Gynecology, 2014, 41(6): 654-658.

URL: 

https://ceog.imrpress.com/EN/10.12891/ceog17592014     OR     https://ceog.imrpress.com/EN/Y2014/V41/I6/654

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