A Clinical Survey of Cesarean Hysterectomy / 대한주산의학회잡지

ABSTRACT

Cesarean hysterectomy remains a necessary procedure for life saving during intractable obstetric hemorrhage. The procedure itself is usually associated with considerable perioperative morbidity, especially when performed under emergency conditions. In this study, the outcomes of 15 cases of cesarean hysterectomy performed at Catholic university of Taegu-Hyosung hospital for 5 years from January, 1993 to December, 1997 were reviewed. There were 22,251 deliveries during this period, cesarean hysterectomy was performed in 13 of 5,753 cesarean section(0.22%) and in 2 of 16,698 vaginal deliveries(0.12%), so more frequently after cesarean section than vaginal deliveries. The age of patients varied from 23 to 39 years old. The higher the age of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of emergency cesarean hysterectomy was in uterine atony(53.3%), followed by placental disorders(33.3%), uterine rupture(6.7%), and uterine myoma with pregnancy (6.7%). All patients who had cesarean hysterectomy received transfusion from 3 pints to 13 pints. In aspect of fetal outcomes, live birth were 12 cases(80%), one case was fetal death in utero(6.6%), 2 infants were dead during the early neonatal period(13.3%) due to prematurity and RDS (respiratory distress syndrome), so the perinatal mortality rate was 20.0%. The postoperative complications were wound disruption, hematoma, febrile morbidity and disseminated intravascular coagulopathy.