Emergency Peripartum hysterectomy: Indications and prognosis

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Published Sep 13, 2012
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Vol. 90 No. 8 (2012): Issue Aug 2012

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Nabil Mathlouthi
Haikel Trabelsi
Sonia Zayen
Habib Amouri
Mohamed Dhouib
Kaies Chaabene
Mohamed Ayadi
Kamel Kolsi
Belhassen Ben Ayed
Mohamed Guermazi

Abstract

Aim: Detect the risk factors, indications and maternel morbidity of haemostatic hysterectomy.
Methods: A retrospective study of 46 women who had haemostatic hysterectomy between 2005 and 2009.
Results: The mean age was 33.3 years. The mean parity was 3.5. 35% of patients had a previous cesarean section. The mode of delivery was: vaginal delivery (47.8%), cesarean delivery (52.2 %). The hysterectomy was subtotal in 39 cases (85%). The indications of haemostatic hysterectomy was: uterine inertia (44%), disseminated intravascular coagulation (26%), placenta accreta (8.7%), Placenta praevia (13%), uterine rupture (8.7%).Three patients were dead. Five patients had a depression. Six patients had a dyspareunia. Five patients had a decrease of sexual desire.
Conclusion: Haemostatic hysterectomy is a mutilating surgery giving an irreversible infertility. The development of arterial embolization avoid the appeal to this surgery.

Keywords:

Hysterectomy - Haemostasis - Post partum hemorrhage- uterine inertia

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