నైరూప్య

Analysis on 50 cases of emergency hysterectomy

Ying Peng, Ling Chen, Da-Bao Wu, Wei-Ping Hu, Hong Li

Objective: This paper aims to discuss the influencing factors and the method for reducing emergency hysterectomy.

Method: The clinical data of 50 patients treated with emergency hysterectomy in our hospital from January of 2007 to March of 2017 were collected from the hospital information system.

Results: A total of 14,253 women had institutional delivery in our hospital from January of 2007 to March of 2017, and 50 patients (0.35%) were treated with emergency hysterectomy. Their ages ranged from 24-45 y (33.52 ± 5.23 in average). They are all multipara, with maximums of eight pregnancies and three deliveries. Their average gestational age was 33.52 ± 5.01 w. Placental implantation (21 cases), pernicious placenta previa (20 cases), and central placenta previa (19 cases) were the three primary reasons for emergency hysterectomy. Among the 50 patients, 47 chose cesarean delivery to terminate pregnancy. The average amount of blood loss was 2,994.00 ± 1,268.84 ml. With respect to hysterectomy mode, total and subtotal hysterectomies were performed in 18 and 31 patients, respectively. In addition, 36 patients had hysterectomy during the operation, and the rest had hysterectomy 24 h after the operation. Two patients suffered ureteral injury, and one had urinary system injury.

Conclusions: Emergency hysterectomy is the ultimate saving method for postpartum hemorrhage, and placental factors are the major causes of hysterectomy. Hysterectomy can reduce the death rate of patients, but it has a negative psychological effect on puerpera. Therefore, appropriate and effective interventions should be adopted to prevent hysterectomy. If hysterectomy is necessary, the indications of the operation must be understood and the appropriate hysterectomy method should be implemented at the appropriate time to reduce injuries to puerpera to the maximum extent.