Clinical Studies on Cesarean Hysterectomy.

Jo, Y C; Park, J W; Kwon, S M; Koh, J H; Kim, Y B; Lee, E S; Park, S K

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Original Article

Korean Journal of Obstetrics & Gynecology 1998;41(10):2599-2603.
Published online January 1, 2001.

Clinical Studies on Cesarean Hysterectomy.

Y C Jo, J W Park, S M Kwon, J H Koh, Y B Kim, E S Lee, S K Park

Abstract

OBJECTIVES
To review 19 cases of cesarean hysterectomy performed at Seoul Paik Hospital, College of Medicine, Inje University from January, 1986 to December, 1997. METHODS: A retrospective study of all cases of cesarean hysterectomy was made, and method of delivery, maternal age, parity, indications for hysterectomy, amounts of transfusion, perinatal mortality, complications were reviewed. RESULTS: Cesarean hysterectomy was performed in 14 of 2, 964 Cesarean sections (0.47% and in 5 of 7, 173 vaginal deliveries (0.07%. The higher the age and the parity of patients, the higher incidence of Cesarean hysterectomy. The most common indication of Cesarean hysterectomy was uterine atony (47.4%), followed by uterine rupture (21.0%), placenta previa with adhesive placenta (15.7%), adhesive placenta (10.6%), uterine myoma with pregnancy (5.3%). All patients who underwent Cesarean hysterectomy received transfusion from 3 to 58 pints. In aspect of fetal outcome, live births were 15 cases (79.0%), 2 infants were still birth (10.5%), 2 infants were dead during early neonatal period (10.5%), so perinatal mortality rate was 21.0%. The postoperative complications were bladder injury, febrile morbidity, disseminated intravascular coagulation, intestinal obstruction and wound hematoma. There were 2 maternal deaths, of which the causes were disseminated intravascular coaglulation. CONCLUSIONS: In spite of operative risks, Cesarean hysterectomy is a necessary life saving operation. Prevention of complications that give rise to hysterectomy and optimally timed surgery should decrease maternal morbidity and mortality.

Key Words: Cesarean hysterectomy, Uterine atony

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