Clinical Evaluation of Cesarean Hysterectomy.

Jeong, Young Ju; Kim, Jong Duk

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Original Article

Korean Journal of Obstetrics & Gynecology 2001;44(6):1097-1102.
Published online June 1, 2001.

Clinical Evaluation of Cesarean Hysterectomy.

Young Ju Jeong, Jong Duk Kim

Department of Obstetrics and Gynecology, College of medicine, Chonbuk National University, Chonju, Korea.

Abstract

OBJECTIVES
The aim of this study was to review 10 years' experience of cesarean hysterectomy at our hospital. METHODS: A retrospective study of 37 cases of cesarean hysterectomy between Jan, 1, 1989, and Dec, 31, 1998 was carried out and then method of delivery, maternal age, parity, indication for hysterectomy, amount of transfusion, factors associated with adhesive placenta, and complications of hysterectomy were analysed. RESULTS: The incidence of cesarean hysterectomy was 1 in 639 deliveries. Overall, 0.55% of cesarean sections and 0.02% of vaginal deliveries were followed by cesarean hysterectomy. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy(p=.000, respectively). The most common indication of cesarean hysterectomy was adhesive placenta(54%). Placenta previa and two more prior cesarean delivery were main risk factors for development of adhesive placenta (Odds ratio: 9.6, 6.1, respectively ; 95% Confidence interval: 2.1-43.5, 1.1-34.2, respectively). Although no maternal deaths occurred, maternal morbidity remained high, including need for transfusion in 29 patients(78%) intraoperative urologic injury in 10 patients(27%), and pulmonary congestion or edema in 7 patients(19%). CONCLUSION: As the incidence of cesarean section and its association with placenta previa and/or accreta continue to rise, we may encounter Cesarean hysterectomy with increasing frequency. Still, cesarean hystere ctomy remains a potentially life saving procedure with which every obstetrician must be familiar.

Key Words: Cesarean hysterectomy, Adhesive placenta

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