Investigación de incidencia y complicaciones de histerectomía de emergencia en periparto / Investigation of Incidence and Complications of Emergency peripartum hysterectomy

Introducción: La histerectomía periparto de emergencia es una cirugía de alto riesgo, que se realiza mayoritariamente después de un parto vaginal o cesárea. Dada la importancia de las complicaciones y la mortalidad de las embarazadas para el sistema de salud, el presente estudio tuvo como objetivo investigar la incidencia y las complicaciones de la histerectomía periparto de emergencia en los hospitales generales y docentes de la Universidad de Ciencias Médicas de Zahedan. Materiales y Métodos: En este estudio descriptivo-analítico transversal, luego de obtener la aprobación del Comité de Ética, se investigó la historia clínica de las pacientes con histerectomía periparto de emergencia ingresadas en el hospital Ali ibn Abitaleb de Zahedan para la interrupción del embarazo durante 2017-2018. fueron estudiados. Después de evaluar las características demográficas, incluida la edad, la educación y la ocupación, se investigaron las causas y las complicaciones de la histerectomía de emergencia. Finalmente, los datos fueron analizados por el software SPSS.Resultados: De 2438 casos, se investigaron 50 casos de histerectomía. La edad media de las madres y el número medio de embarazos fue de 31,06 ± 5,21 y 5,72 ± 2,31, respectivamente. En este estudio, se registraron 35 cesáreas (70%) y 15 partos vaginales normales (30%), y solo el 2% condujo a una histerectomía de emergencia. Las causas más comunes de histerectomía de emergencia incluyeron placenta accreta (28%), atonía uterina (24%) y rotura uterina (20%). Las complicaciones también incluyeron fiebre (24%), coagulopatía (14%) e infección de la herida (12%). Conclusión: la placenta accreta y la atonía uterina son las causas más importantes de histerectomía. Las complicaciones más comunes de la histerectomía de emergencia son fiebre, coagulopatía e infecciones de heridas. Una disminución en el parto por cesárea electiva y un mayor fomento del parto vaginal natural podrían reducir significativamente la incidencia de histerectomía periparto y la mortalidad materna

Introduction: The emergency peripartum hysterectomy is a high-risk surgery, which is mostly performed after vaginal delivery or Caesarean section. Given the importance of complications and mortality of pregnant mothers for the health system, the present study aimed to investigate the incidence and complications of emergency peripartum hysterectomy in general and teaching hospitals of Zahedan University of Medical Sciences. Materials and Methods: In this cross-sectional descriptive-analytic study, after obtaining the Ethics Committee approval, the medical record of patients with emergency peripartum hysterectomy admitted to Ali ibn Abitaleb hospital of Zahedan for pregnancy termination during 2017-2018 were investigated. were studied. After evaluating demographic characteristics, including age, education, and occupation, causes, and complications of emergency hysterectomy were investigated. Finally, data were analyzed by SPSS software. Results: Out of 2438 cases, 50 cases of hysterectomy were investigated. The mean age of mothers and the average number of pregnancies was 31.06±5.21 and 5.72±2.31, respectively. In this study, 35 caesarean sections (70%) and 15 normal vaginal delivery (30%) were recorded, with only 2% leading to emergency hysterectomy. The most common causes of emergency hysterectomy included placenta accreta (28%), uterine atony (24%), and uterine rupture (20%). The complications also included fever (24%), coagulopathy (14%), and wound infection (12%). Conclusion: Placenta accreta and uterine atony are the most important causes of hysterectomy. The most common complications of emergency hysterectomy are fever, coagulopathy, and wound infections. A decrease in elective caesarean delivery and further encouraging to natural vaginal delivery could significantly reduce the incidence of peripartum hysterectomy and maternal mortality

Measurement of Homocysteine Levels in Pregnant Women with and Without Preeclampsia

Introduction:Homocysteine is associated with endothelial dysfunction and cardiovascular disease, and elevated concentrations of homocysteinehave been found in preeclampsia. The aim of this study was to determine homocysteine levels in pregnant women with and without preeclampsia. Methods:This descriptive study conducted on pregnant women with preeclampsia (n = 39) and controls (n = 43) was evaluated by the convenience samplingand data were collected through a questionnaire and paraclinical findings. In the present study, 5cc blood samples were taken from the patients after 8 hours of fasting and sent to the laboratory to determine homocysteine and related metabolites levels. Statistical analyses were done using IBM-SPSS 25.0 and Chi-square test wasused for data analysis. Results:The moderate concentrations of homocysteine and uric acid were significantly higher than the control group in maternal plasma with preeclampsia (0.0001). Conclusion:We found that the blood homocysteine levels were significantly higher in the preeclampsia group compared with the Controls group. Measuring uric acid and blood homocysteine levels in pregnancy may be helpful as diagnostic tests in the early detection of high risk individuals