EVALUATION OF PERIPARTUM HYSTERECTOMY CASES: EXPERIENCES OF A TERTIARY HEALTH CENTER IN WESTERN REGION OF TURKEY

Abstract

OBJECTIVE: We aimed to retrospectively examine the cases of peripartum hysterectomy performed in our clinic in the last three years and to evaluate the incidence, risk factors, indications, surgical methods, complications, and results of peripartum hysterectomy.MATERIAL AND METHODS: Patients who had undergone a peripartum hysterectomy in Pamukkale University Medical Faculty Hospital between January 2017 and January 2020 were included in the study. We excluded all patients with the massive peripartum hemorrhage who were treated with conservative approaches (such as suturing or segmental resection of the defective placenta insertion area, uterine compression sutures, intrauterine balloon applications, and uterine or internal iliac artery ligation) rather than hysterectomy. Data of the patients were obtained from patient files and hospital medical records. The demographic and clinical data of the patients were recorded and analyzed.RESULTS: During the three years, a total of 3220 births took place in our hospital. Peripartum hysterectomy was performed in twenty-one patients; the incidence was 6.5/1000. The most common indication for peripartum hysterectomy in the postpartum hemorrhage group was placental location and invasion anomalies (90.4%) and among these anomalies, the most common histopathological diagnosis was the association of placenta previa and placenta increta (33.33%). Massive transfusion, bladder damage, relaparotomy, and wound infection were the major causes of morbidity in patients with peripartum hysterectomy.CONCLUSIONS: Recently, placental location and invasion anomalies have become the most common cause of peripartum hemorrhages. Peripartum hysterectomy is the leading treatment method for patients with abnormal placentation.