Emergency peripartum hysterectomy (EPH) is performed for massive postpartum hemorrhage following a cesarean delivery or vaginal delivery, in order to save the patient’s life. The current study was performed on a sample of 13.162 patients, which underwent cesarean or vaginal delivery during a period of 6 years, from 2010 to 2015, in Bucur Maternity Hospital. There were two subsequential groups consisting in: 6593 patients with cesarean operations and 6569 patients with vaginal delivery. In 12 cases occurred one or more of the risk factors that lead to EPH, divided equally across the two groups above.
The main two types of surgery are a more frequent subtotal hysterectomy, which is the preferred type of EPH as it takes less time and is associated with fewer complications, and a total hysterectomy. The majority of procedures were performed at patients over 35 years old (9 of 12), with a median age of 31,16 (ranging from 21 to 44 years old). The most important risk factor present across the lot was multiparity (11 from 12), with cicatricial uterus being the second one (4 of 12).
ICU median time was 4,5 days (ranging from 3 to 15 days), with a median blood transfusion necessity of around 2,4 I.U per patient. There were no mother or newborn reported deaths, neither PTSD following EPH.EPH is a procedure performed as last-resort, life-saving surgery, leaving no time for mental preparation of the patients. This may predispose to negative psychological outcomes, especially because they are not part of decision-making process due to the emergency character of hysterectomy.
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Balalau, Denisa Oana; Sima, Romina Marina; Bacalbașa, Nicolae; Pleș, Liana; and Stănescu, Anca Daniela
"Emergency peripartum hysterectomy, physical and mental consequences: a 6-year study,"
Journal of Mind and Medical Sciences: Vol. 3
, Article 8.
Available at: https://scholar.valpo.edu/jmms/vol3/iss1/8