Planned cesarean hysterectomy: A preferred alternative to separate operations

Seago, D.Paul; Roberts, William S.; Johnson, Venessia; Martin, Rick W.; Morrison, John C.; Martin, James N.

doi:10.1016/s0002-9378(99)70023-2

Cited by 21 publications

(16 citation statements)

References 12 publications

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“…This is in contrast to older studies, descriptions of predominantly elective or non-emergent procedures (4,8,9,11). As the frequency of complications associated with non-emergent cesarean hysterectomy is comparatively low, some have advocated the option of elective cesarean hysterectomy in select cases (21). Direct comparison of elective versus emergent cases in two studies demonstrated that elective cases clearly are associated with less blood loss, febrile morbidity, and shorter operative times (22,23).…”

Section: Discussionmentioning

confidence: 92%

The Frequency and Complication Rates of Hysterectomy Accompanying Cesarean Delivery

Shellhaas

Gilbert

Landon

et al. 2010

Obstetric Anesthesia Digest

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Objective-To estimate the frequency, indications, and complications of cesarean hysterectomy.Methods-This was a prospective, 2-year observational study at 13 academic medical centers conducted between January 1, 1999 and December 31, 2000 on all women who underwent a hysterectomy at the time of cesarean delivery. Data was abstracted from the medical record by study nurses. The outcomes included procedure frequency, indications, and complications.Results-A total of 186 cesarean hysterectomies (0.5%) were performed from a cohort of 39,244 women who underwent cesarean delivery. The leading indications for hysterectomy were placenta accreta (38%) and uterine atony (34%). Of the hysterectomy cases with a diagnosis recorded as accreta, 18% accompanied a primary cesarean delivery while 82% had a prior procedure (p<0.001). Of the hysterectomy cases with atony recorded as a diagnosis, 59% complicated primary cesarean delivery whereas 41% had a prior cesarean (p< 0.001). Major maternal complications of cesarean hysterectomy included transfusion of red blood cells (84%) and other blood products (34%), fever (11%), subsequent laparotomy (4%), ureteral injury (3%), and death (1.6%). Accreta hysterectomy cases were more likely than atony hysterectomy cases to require ureteral stents (14% versus 3%, p=0.03) and to instill sterile milk into the bladder (23% versus 8%, p=0.02).Conclusion-The rate of cesarean hysterectomy has declined modestly in the last decade. In spite of the use of effective therapies and procedures to control hemorrhage at cesarean delivery, a small proportion of women continue to require hysterectomy to control hemorrhage from both uterine atony and placenta accreta.

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Section: Discussionmentioning

confidence: 92%

The Frequency and Complication Rates of Hysterectomy Accompanying Cesarean Delivery

Shellhaas

Gilbert

Landon

et al. 2010

Obstetric Anesthesia Digest

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“…This material conforms with that pattern as in the last period more than two-thirds of cases were operated for acute bleeding complications, the preponderance of cases being placenta accretas and previas (often superimposed). Nevertheless, recent reports show that peripartum hysterectomy may have less morbidity than C-section and tubal ligation [2], or that it may be more cost-effective without increased complications than C-section and subsequent hysterectomy [15,19].…”

Section: Indicationsmentioning

confidence: 99%

“…With the advent and acceptance of elective sterilization, and al-Ą 2000 by Walter de Gruyter GmbH & Co. KG Berlin · New York most simultaneously the introduction into practice of laparoscopy, the indications for this major operation have become almost exclusively emergent occurring complications [4, 7, 8, 16Ϫ18, 20]. The teaching institutions must prepare their trainees to be ready to do this operation safely because the gross vascular anatomy observed in the pelvis at the end of pregnancy is so different from that found in gynecologic surgery that a good gynecologic surgeon may have difficulty in executing it safely, unless he (she) has done some cases under supervision of experienced colleagues [2,8,15]. With these considerations in mind it was decided to review the experience with this operation at the Chicago Lying-in Hospital following the last publication from this institution by Davis and McKeown [6].…”

Section: Introductionmentioning

confidence: 99%

Peripartum hysterectomy

Castaneda¹,

Karrison²,

Cibils³

2000

Journal of Perinatal Medicine

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“…Postpartum histerektomi, özellikle acil koflullarda yap›ld›¤›nda, oldukça riskli ve yüksek komplikasyon oran›na sahip bir prosedürdür (2) . Plasenta invazyon anomalisi günümüzde postpartum histerektominin en s›k endikasyonunu oluflturmaktad›r (3) .…”

Section: G‹r‹fiunclassified