Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go!
Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hys...
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doaj-f3e70b5dea7f40fb8faaf52f467308002020-11-24T23:25:37ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852017-01-0133332432810.4103/joacp.JOACP_380_16Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go!Bharti SharmaPooja SikkaVanita JainKajal JainRashmi BaggaVanita SuriBackground and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies. Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital. The study included all women who underwent peripartum hysterectomy in a teaching hospital and referral institute in North India over a span of 1 year (April 1, 2014, to March 31, 2015). Association of variables was based on Chi-square test, Fisher's exact test, and comparison on “t” statistics (normal distribution) and Mann–Whitney (nonnormal distribution). Results: Forty women underwent peripartum hysterectomy during the study period. The incidence was 6.9/1000 deliveries. In 16 (40%) cases, peripartum hysterectomy was planned electively while emergency hysterectomy was done in 24 (60%) cases. Main indications of peripartum hysterectomies were placenta accreta (60%), atonic postpartum hemorrhage (PPH) (27.5%), and uterine rupture (7.5%). Intensive care management was required in 35% women postoperatively. The common maternal complications were febrile morbidity, bladder injury, disseminated intravascular coagulation, and wound infection. There were 4 maternal deaths following emergency peripartum hysterectomy done for atonic PPH whereas no mortality occurred in elective hysterectomy group. Conclusions: The most common indication for peripartum hysterectomy was placenta accrete. Electively planned peripartum hysterectomies with a multidisciplinary team approach had better outcomes and no mortality as compared to emergency peripartum hysterectomies.http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=3;spage=324;epage=328;aulast=SharmaNear miss eventperipartum hysterectomyplacenta accretepostpartum hemorrhage |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Bharti Sharma Pooja Sikka Vanita Jain Kajal Jain Rashmi Bagga Vanita Suri |
spellingShingle |
Bharti Sharma Pooja Sikka Vanita Jain Kajal Jain Rashmi Bagga Vanita Suri Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! Journal of Anaesthesiology Clinical Pharmacology Near miss event peripartum hysterectomy placenta accrete postpartum hemorrhage |
author_facet |
Bharti Sharma Pooja Sikka Vanita Jain Kajal Jain Rashmi Bagga Vanita Suri |
author_sort |
Bharti Sharma |
title |
Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! |
title_short |
Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! |
title_full |
Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! |
title_fullStr |
Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! |
title_full_unstemmed |
Peripartum hysterectomy in a tertiary care hospital: Epidemiology and outcomesImproving outcomes for peripartum hysterectomy: Still a long way to go! |
title_sort |
peripartum hysterectomy in a tertiary care hospital: epidemiology and outcomesimproving outcomes for peripartum hysterectomy: still a long way to go! |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Anaesthesiology Clinical Pharmacology |
issn |
0970-9185 |
publishDate |
2017-01-01 |
description |
Background and Aims: Peripartum hysterectomy is associated with significant maternal morbidity and mortality. We reviewed all peripartum hysterectomies at our institute over a 1-year period. The aim of this study was to determine the incidence, surgery and anesthesia-related issues of peripartum hysterectomies and to compare outcomes of emergency and electively planned peripartum hysterectomies.
Material and Methods: This was a retrospective analysis of records of women who underwent emergency or elective peripartum hysterectomy in a tertiary care hospital. The study included all women who underwent peripartum hysterectomy in a teaching hospital and referral institute in North India over a span of 1 year (April 1, 2014, to March 31, 2015). Association of variables was based on Chi-square test, Fisher's exact test, and comparison on “t” statistics (normal distribution) and Mann–Whitney (nonnormal distribution).
Results: Forty women underwent peripartum hysterectomy during the study period. The incidence was 6.9/1000 deliveries. In 16 (40%) cases, peripartum hysterectomy was planned electively while emergency hysterectomy was done in 24 (60%) cases. Main indications of peripartum hysterectomies were placenta accreta (60%), atonic postpartum hemorrhage (PPH) (27.5%), and uterine rupture (7.5%). Intensive care management was required in 35% women postoperatively. The common maternal complications were febrile morbidity, bladder injury, disseminated intravascular coagulation, and wound infection. There were 4 maternal deaths following emergency peripartum hysterectomy done for atonic PPH whereas no mortality occurred in elective hysterectomy group.
Conclusions: The most common indication for peripartum hysterectomy was placenta accrete. Electively planned peripartum hysterectomies with a multidisciplinary team approach had better outcomes and no mortality as compared to emergency peripartum hysterectomies. |
topic |
Near miss event peripartum hysterectomy placenta accrete postpartum hemorrhage |
url |
http://www.joacp.org/article.asp?issn=0970-9185;year=2017;volume=33;issue=3;spage=324;epage=328;aulast=Sharma |
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