Frequency, indications and complications of obstetric hysterectomy at Hospital Universitario de San José in Popayán, 2006-2010. Cohort study
DOI:
https://doi.org/10.18597/rcog.119Keywords:
Hysterectomy, bleeding, placenta accretaAbstract
Objective: To determine the frequency, indications and complications of obstetric hysterectomy (OH).
Materials and methods: Descriptive cohort study in patients undergoing hysterectomy for obstetric indications at Hospital Universitario San José in Popayán, Colombia, between January 1st, 2006 and May 31st, 2010. The hospital is a Level III institution offering care to uninsured poor populations as well as patients covered under the subsidized and contributive insurance regimes in the Department of Cauca and the larger southwestern region of Colombia. Consecutive sampling was used and the variables measured were: sociodemographic, gestational age; obstetric history; prior vaginal delivery or cesarean section; indication for OH; length of hospital stay; admission to the Intensive Care Unit (ICU); need for transfusion; complications and maternal and perinatal mortality. Results are presented in proportion terms.
Results: A total of 49 OH were performed. Over the same period, 8,167 obstetric patients were admitted. The hysterectomy incidence was 5.9 per 1000 births. The most frequent indications were uterine atony (43.37%) and placental insertion abnormalities (18.24%); perinatal mortality was high at 32.6%, anemia was the most frequent complication (76.3%) and there were no cases of maternal mortality
Conclusions: The main indication for OH was uterine atony, followed by placental insertion abnormalities, uterine rupture, myometritis, abruptio placentae and septic miscarriage. OH represents a safe and timely management option for post-partum bleeding that does not respond to conventional pharmacological or surgical treatment.
Author Biographies
Rodolfo L. Casas-Peña
Ibey Lorena Pérez-Varela
Gustavo A. Chicangana-Figueroa
References
Faneite P, Rivera C, Faneite J. Histerectomía obstétrica 2000-2007. Rev Obstet Ginecol Venez. 2008;68:92-7.
Uribe R. Histerectomía obstétrica. Concepto e importancia. Ginec Obst Mex. 2004;64:23.
Flood KM, Said S, Geary M, et al. Changing trends in peripartum hysterectomy over the last 4 decades. Am J Obstet Gynecol. 2009;200:632.e1-632.e6.
Villalobos N, López C. Análisis de las indicaciones para histerectomías obstétricas. Rev Obstet Ginecol Venez. 1999;59:7-11.
Reveles J, Villegas G, Hernández S, Grover F, Hernández C, Patiño A. Histerectomía obstétrica: incidencia, indicaciones y complicaciones. Ginecol Obstet Mex. 2008;76:156-60.
Caro J, Bustos L, Ríos A, Bernales J, Neumann Pape C. Histerectomía obstétrica en el Hospital de Puerto Montt, 2000-2005. Rev Chil Obstet Ginecol. 2006;71:313-9.
Arrieta O. Notas para la historia de la Medicina del Zulia. Maracaibo: Talleres Ars Gráfica; 1988. p. 92-93.
Speert H. Part IX. Operations and Therapeutic Procedures. Obstetrics & Gynecologic Milestones illustrated. 2nd ed. Carnforth: The Parthenon Publishing Group; 2000. p. 572-77.
Guzman R, Vargas P, Astudillo J, Riveros R, Yamamoto M. Embolización selectiva de arterias uterinas en la resolución de patologías ginecológicas y emergencias obstétricas. Rev Chil Obstet Ginecol. 2011;76:76-85.
Villar R, Aguarón G, González-López A, Arones M, González de Merlo G. Técnica B-Lynch para el tratamiento de la hemorragia posparto. Clin Invest Ginecol Obstet. 2012;39:64-8.
Torres S, Albigés G, Rodríguez M et al. Atonía uterina como causa más frecuente de histerectomías postparto. Ginecología y Obstetricia Clínica. 2006;7:10-5.
Kastner E, Figueroa R, Garry D, Maulik D. Emergency peripartum hysterectomy: experience at a community teaching hospital. Obstet Gynecol. 2002;99:971-5.
Whiteman MK, Kurlina E, Hillis SD, Jamiesom DJ. Incidence and determinants of peripartum hysterectomy. ACOG. 2006;108:1486-92.
Stanco M, Paul H, Mishell R. Emergency peripartum hysterectomy and associated risk factors. Am J Obstet Gynecol. 2003;168:879-83.
Kacmar J, Bhimani L, Boyd M, Shah-Hosseini R, Peipert JF. Route of delivery as a risk factor for emergent peripartum hysterectomy: A case-control study. ACOG. 2003;102:141-5.
Briceño-Pérez C, Briceño-Sanabria L, García S, Jaimes T, Briceño-Sanagria JC, Briceño-Sanabria C. Histerectomía obstétrica: análisis de 15 años. Rev Obstet Ginecol Venez. 2009;69:89-96.
Ramos GR, Ramírez LG, Hurtado EG Indicaciones de histerectomía obstétrica en el Hospital de Ginecología y Obstetricia del Instituto Materno Infantil del Estado de México del 2007 al 2008. Archivos de Investigación Materno Infantil. 2010;2:11-4.
Isla A, Requena L, Zayas M, Pérez R, Giraldo G. Comportamiento de las histerectomías obstétricas. Resultados de 6 años. Rev Cubana Obstet Ginecol. 2005 Dic (citado 2013 Jul 08); 31(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-600X2005000300002&lng=es.
Uribe R, Acosta A. La histerectomía obstétrica. Evolución y cambio. Ginec Obstet Mex. 1996;64:338-40.
Quesnel B, Ahued J, Rivera J, Oberd J. Histerectomía obstétrica. Revisión de 675 casos en el instituto Nacional de perinatología. Ginec Obstet Mex. 2003;65:119-24.
Abu T, Jallad F. Emergency peripartum hysterectomy at the princess Badeca Teaching Hospital in North Jordan. J Obstet Gynecol Res. 2005;25:193-5.
Rodriguez G, Rodriguez A, Aparicio Z. Histerectomía obstétrica. Estudio de tres años. Archivos de Medicina. 2008;2:1-12.
Castañeda S, Harrison T, Cibilis LA. Peripartum hysterectomy. J Perinat Med. 2000;28:472-81.
Tisné L, Aguilera B, Sepúlveda K, Lattus J, Pantoja V, Moscoso F, et al. Histerectomía obstétrica de emergencia. Experiencia en el Hospital Santiago Oriente. Rev Chil Obstet Ginecol. 2006;1:39-44.
Faneite P, Rivera C, Faneite J. Histerectomía obstétrica (2000-2007). Rev Obstet Ginecol Venez. 2008:68:92-7.
Organización Mundial de la Salud. Mortalidad materna en 2005. Estimaciones elaboradas por la OMS, Unicef, Unfpa y el Banco Mundial; 2008.
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