|
Emergency Peripartum Hysterectomy from PostpartumHemorrhage in Sisaket Hospital: Clinical characteristicsand risk factors |
|---|---|
| รหัสดีโอไอ | |
| Creator | Piyawat Angkawanich, M.D. |
| Title | Emergency Peripartum Hysterectomy from PostpartumHemorrhage in Sisaket Hospital: Clinical characteristicsand risk factors |
| Publisher | PIMDEE Co., Ltd. |
| Publication Year | 2559 |
| Journal Title | Thai Journal of Obstetrics and Gynaecology |
| Journal Vol. | 24 |
| Journal No. | 2 |
| Page no. | 81-88 |
| Keyword | Emergency peripartum hysterectomy, clinical characteristics, risk factors |
| ISSN | 0857-6084 |
| Abstract | Background: Postpartum hemorrhage remains a leading cause of maternal death. Although therehad been the improvement of various treatments, such as prostaglandin and ?-Lynch suture,some women did not respond to these treatments and needed Emergency peripartumhysterectomy (EPH) to control intractable bleeding. The aim of this study was to determineclinical characteristics associated with EPH in Sisaket Hospital.Objective: To determine the incidence, indications, clinical characteristics and risk factorsinflencing EPH.Design: A retrospective hospital-based descriptive and case control study.Setting: Department of Obstetrics and Gynecology, Sisaket Hospital.Methods and Materials: Women who was pregnant 28 weeks gestational age or more and carriedout EPH within 24 hours after delivery at Sisaket Hospital from January 2012 to June 2015 (total26 cases) were identifid from labor registration records. Their medical records were reviewedto assess the following outcomes (1) incidence of EPH (2) indications for EPH (3) clinicalcharacteristics and risk factors associated with EPH (4) complications after EPH. Women whogave birth before (2 cases) and after (2 cases) the cases of EPH (total 104 cases ) were thecontrol used to assess the risk factors associated with EPH.Result: During the study period, there were 17,566 deliveries at 28 weeks gestational age ormore. Among them, there were 26 cases undergoing EPH. The incidence was 1.48 per 1,000deliveries. Medical records showed that placenta adherent (65.38%) was the most commonindication of EPH followed by uterine atony (26.92%) and uterine rupture (7.69%). The signifiantrisk factors affecting EPH by multivariate logistic regression analysis were maternal age ? 35years, cesarean delivery and delivery at 28-36 weeks gestational age. There were two maternaldeaths after EPH.Conclusions: Clinical characteristics and risk factors associated with EPH were age ? 35 years,cesarean delivery and delivery at GA28-36weeks. |
