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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(01): 003-008
DOI: 10.1055/s-0040-1721354
Original Article
Obstetrics/High Risk Pregnancy

Peripartum Hysterectomies over a Fifteen-year Period

Histerectomias periparto ao longo de um período de quinze anos
Alessandra Dorigon 
1   Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
,
Sérgio Hofmeister Martins-Costa 
1   Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
José Geraldo Lopes Ramos 
1   Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
2   Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Abstract

Objective To determine the indications and outcomes of peripartum hysterectomies performed at Hospital de Clínicas de Porto Alegre (a university hospital in Southern Brazil) during the past 15 years, and to analyze the clinical characteristics of the women submitted to this procedure.

Methods A cross-sectional study of 47 peripartum hysterectomies from 2005 to 2019.

Results The peripartum hysterectomies performed in our hospital were indicated mainly due to placenta accreta or suspicion thereof (44.7% of the cases), puerperal hemorrhage without placenta accreta (27.7%), and infection (25.5%). Total hysterectomies accounted for 63.8% of the cases, and we found no difference between total versus subtotal hysterectomies in the studied outcomes. Most hysterectomies were performed within 24 hours after delivery, and they were associated with placenta accreta, placenta previa, and older maternal age.

Conclusion Most (66.0%) patients were admitted to the intensive care unit (ICU). Those who did not need it were significantly older, and had more placenta accreta, placenta previa, or previous Cesarean delivery.

Resumo

Objetivo Determinar as indicações e os desfechos das histerectomias periparto realizadas no Hospital de Clínicas de Porto Alegre nos últimos 15 anos, bem como analisar as características clínicas das mulheres submetidas a esse procedimento.

Métodos Estudo transversal de 47 histerectomias periparto realizadas no período de 2005 a 2019.

Resultados Em nosso hospital, as histerectomias periparto foram indicadas principalmente por acretismo placentário ou sua suspeita (44,7% dos casos), hemorragia puerperal sem acretismo placentário (27,7%), e infecção (25,5%). Histerectomias totais corresponderam a 63,8% dos casos, e não encontramos diferença entre histerectomia total e subtotal para os desfechos estudados. A maioria das histerectomias foi realizada dentro de 24 horas após o parto, o que estava associado a acretismo placentário, placenta prévia, e idade materna mais avançada.

Conclusão A maioria (66,0%) das mulheres necessitou de internação em unidade de terapia intensiva (UTI); aquelas que não necessitaram eram significativamente mais velhas, e tinham mais acretismo placentário, placenta prévia, ou cesárea prévia.

Keywords

puerperal hysterectomy - postpartum hemorrhage - placenta accreta - placenta previa

Palavras-chave

histerectomia puerperal - hemorragia pós-parto - placenta acreta - placenta prévia

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.




Publication History

Received: 01 April 2020

Accepted: 30 September 2020

Article published online:
29 January 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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